Organization
BRADLEY IN HOME SERVICE, LLC
Active
Other names
BRADLEY INHOME SERVICE, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MAIRIO RENWICK BRADLEY (OWNER)
(314) 833-3050
Entity
Organization
Contact information
Practice address
141 N MERAMEC AVE STE 300, CLAYTON, MO 63105-3750
(314) 791-0109
(314) 833-3058
Mailing address
141 N MERAMEC AVE STE 300, CLAYTON, MO 63105-3750
(314) 791-0109
(314) 833-3058
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1457750135
—
MO
Enumeration date
08/19/2014
Last updated
03/26/2024
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