Organization
BRALEY & THOMPSON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEENA OMBRES (PRIVACY OFFICER)
(502) 394-2387
Entity
Organization
Contact information
Practice address
1 DUNBAR PLZ # 100, DUNBAR, WV 25064-3038
(304) 720-1300
Mailing address
9901 LINN STATION RD, LOUISVILLE, KY 40223-3808
(800) 866-0860
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0005280001
—
WV
Enumeration date
04/06/2009
Last updated
04/06/2009
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