MEDICARE: GALA MARIE BRADY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	146D00000X	Personal Emergency Response Attendant
2	3747A0650X	Attendant Care Provider
3	376J00000X	Homemaker
4	385H00000X	Respite Care
5	3747P1801X	Personal Care Attendant

General Provider Information

NPI Number	:	1992391411
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GALA MARIE BRADY

Provider Business Mailing Address
First Line	:	1812 NIGHT STORM AVE
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89081-3023
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1812 NIGHT STORM AVE
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89081-3023
Country	:	US
Telephone Number	:	702-240-3800
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/18/2020
Last Update Date	:	12/18/2020

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Directions to “ GALA MARIE BRADY ” Practice Location

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