Organization
ROSA BRADLEY'S HOME FOR ADULTS,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. REGINALD KEITH SHERARD MD (OWNER)
(252) 752-3237
Entity
Organization
Contact information
Practice address
2215 NORTH MEMORIAL DRIVE, GREENVILLE, NC 27834-5026
(252) 752-3237
Mailing address
PO BOX 819, GREENVILLE, NC 27835-0819
(252) 752-3237
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
FCL-074-035
NC
Other
Enumeration date
01/23/2008
Last updated
01/23/2008
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