Organization
BRALEY THOMPSON
Active
Organization
BRALEY THOMPSON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DEENA OMBRES (PRIVACY OFFICER)
(502) 394-2387
Entity
Organization
Contact information
Practice address
1 DUNBAR PLZ, SUITE 100, DUNBAR, WV 25064-3038
(800) 866-0860
Mailing address
9901 LINN STATION RD, LOUISVILLE, KY 40223-3808
(800) 866-0860
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0005269000
—
WV
05
—
0005280003
—
WV
Enumeration date
06/21/2007
Last updated
05/22/2008
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