Organization
BRADLEY HOME CARING FOR WAKE COMMUNITY AND CAROLINAS
Active
Other names
Bradley Home
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CORDELIA AKAGHA MPH (DIRECTOR)
(919) 772-9382
Entity
Organization
Contact information
Practice address
1505 KELLY RD, GARNER, NC 27529-4107
(919) 772-0053
Mailing address
PO BOX 2055, GARNER, NC 27529-2055
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
MHL-092-319
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7803512
—
NC
05
—
7803935
—
NC
05
—
7805168
—
NC
Enumeration date
05/25/2007
Last updated
08/22/2020
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