Provider Demographics
NPI:1881303923
Name:BRADLEY CARE SERVICES LLC
Entity type:Organization
Organization Name:BRADLEY CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:EBONI
Authorized Official - Middle Name:GWENDOLYN
Authorized Official - Last Name:BRADLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-262-7372
Mailing Address - Street 1:24100 SOUTHFIELD RD STE 335E
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-2819
Mailing Address - Country:US
Mailing Address - Phone:248-262-7372
Mailing Address - Fax:
Practice Address - Street 1:24100 SOUTHFIELD RD STE 335E
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-2819
Practice Address - Country:US
Practice Address - Phone:248-262-7372
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-17
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376K00000XNursing Service Related ProvidersNurse's AideGroup - Multi-Specialty
No251E00000XAgenciesHome Health