Organization · NPI-2

Bradley Home Caring For Wake Community And Carolinas

Residential Treatment Facility, Intellectual and/or Developmental Disabilities · Raleigh, NC

NPI number1952512295
StatusActive
Last updated in NPPESAug 22, 2020

Details

NPI
1952512295
Entity type
Organization (NPI-2)
Legal business name
Bradley Home Caring For Wake Community And Carolinas
Organization subpart
No
Enumeration date
May 25, 2007
Last updated
Aug 22, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
320600000X Residential Treatment Facility, Intellectual and/or Developmental DisabilitiesMHL-092-412NCYes

Other names

  • Kimberly House (Doing Business As)

Practice location

6420 Malibu Dr
Raleigh, NC 27603-4908

Phone 919-772-9382 · Fax 919-772-9382

Mailing address

Po Box 2055
Garner, NC 27529-2055

Phone 919-772-9382 · Fax 919-772-9382

Authorized official

Cordelia Akagha
Director
9197729382

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Residential Treatment Facility, Intellectual and/or Developmental Disabilities providers in Raleigh, NC