Organization
CAVHS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN LEIGH BRADLEY CTRS (CERT. RECREATION THERAPIST)
(501) 257-3469
Entity
Organization
Contact information
Practice address
2220 FT ROOTS DRIVE, NORTH LITTLE ROCK, AR 72114-1706
(501) 257-3469
Mailing address
2220 FT. ROOTS DRIVE 116B NLR, NORTH LITTLE ROCK, AR 72114-1706
(501) 257-3469
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
CERT. ID # 22745
NY
314000000X
Skilled Nursing Facility
Primary
22745
NY
Other
Enumeration date
12/08/2008
Last updated
12/08/2008
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