BRADLEY HOME CARING FOR WAKE COMMUNITY & CAROLINAS (NPI# 1124239462) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124239462 |
| Entity Type | Organization |
| Organization Name | BRADLEY HOME CARING FOR WAKE COMMUNITY & CAROLINAS |
| Other Organization Name | PKEDS HOUSE |
| Practice Address |
907 Frances Dr Garner NC 27529-4242 |
| Mailing Address |
Po Box 2055 Garner NC 27529-2055 |
| Practice Telephone | 9197729382 |
| Practice Fax Number | 9197729382 |
| Mailing Telephone | 9197729382 |
| Mailing Fax Number | 9197729382 |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. CORDELIA AKAGHA (DIRECTOR) |
| Authorized Official Telephone | 9197729382 |
| Authorized Official Credential | MPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | MHL-092-610 | NC | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| PKEDS House | Doing Business As Name - Organization |
| Street Address |
907 FRANCES DR |
| City | GARNER |
| State | NC |
| Zip Code | 27529-4242 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578112579 | Ascend Rehab Therapy | Speech-Language Pathologist | 45 Waterpine Drive, Garner, NC 27529 | 2019-09-11 |
| 1760039937 | Direct Realistic Counseling Sevices | Counselor | 503 Highway 70, Suite R, Garner, NC 27529 | 2019-08-22 |
| 1285281402 | Direct Solutions Counseling Services | Counselor | 503 R Highway 70, Garner, NC 27529 | 2019-08-22 |
| 1821551920 | Rex Hospital Inc | Emergency Medicine | 1165 Us Hwy 70 W, Garner, NC 27529 | 2019-04-08 |
| 1154888485 | First Step Services, LLC | Social Worker | 1418 Aversboro Road, Suite 201, Garner, NC 27529 | 2019-02-22 |
| 1528533387 | Pratibha Verma | Physical Therapist | 200 Bellarose Nursing and Rehab, Garner, NC 27529 | 2018-10-09 |
| 1073037271 | Kim Robert Rogers | Marriage & Family Therapist | 1140 Holly Springs Road #207, Holly Springs, NC 27529 | 2017-07-29 |
| 1790214062 | Diversified Services of Nc LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 255 Adams Point Dr, Garner, NC 27529 | 2017-06-08 |
| 1972049369 | Michelle Stephens | Case Manager/Care Coordinator | 7017 Scarlett Ln, Garner, NC 27529 | 2017-01-10 |
| 1962854877 | Brittany H Mccrann | Social Worker | 310 New Fidelity Ct, Garner, NC 27529 | 2016-07-05 |
| Find all providers in zip 27529 | ||||
| Taxonomy Code | 320600000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790214062 | Diversified Services of Nc LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 255 Adams Point Dr, Garner, NC 27529 | 2017-06-08 |
| 1922447424 | Mcneil Home - Southerlund | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1014 Southerland Road, Garner, NC 27529 | 2013-06-18 |
| 1811336654 | Mcneil Home #3 | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 611 Mckay Place, Garner, NC 27529 | 2013-06-14 |
| 1508205337 | Richardson Home | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 902 Creech Road, Garner, NC 27529 | 2013-06-14 |
| 1306182738 | First Alternative Community Support | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 106 Cheney Ct, Garner, NC 27529-4523 | 2012-12-12 |
| 1982815221 | Bradley Home Caring for Wake Community and Carolinas | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1505 Kelly Rd, Garner, NC 27529-4107 | 2007-05-25 |
| 1164853966 | Donald Hassell | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 106 Cheney Ct, Garner, NC 27529-4523 | 2013-12-03 |
| 1316371107 | Hassell Afl Home Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 106 Cheney Ct, Garner, NC 27529-4523 | 2013-08-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578160552 | Residential Option Serving Adolescents, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2316 Carved Tree Ln, Charlotte, NC 28262-3154 | 2020-10-03 |
| 1649895442 | Gaynelle Bolling | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 102 Mandarin Dr, Pikeville, NC 27863-0020 | 2020-06-08 |
| 1851913966 | Johnson Enrichment Services LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 221 Foxcroft Dr, Winston Salem, NC 27103-5313 | 2020-05-12 |
| 1881230795 | Walter Jason Young Jr. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 412 Rook Rd, Charlotte, NC 28216-3199 | 2019-11-26 |
| 1750935839 | Heavenly Touch Residential Care | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4720 Baileys Lake Rd Nw Apt 204, Concord, NC 28027-8576 | 2019-07-28 |
| 1073166245 | Making Kids Matter, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 409 Hunton Forest Dr Nw, Concord, NC 28027-0186 | 2019-07-17 |
| 1891357752 | New Hope for Tomorrow LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 528 Baldwin Rd, Burlington, NC 27217-1702 | 2019-07-01 |
| 1114490877 | Brenda Gail Cannon | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3105 Vico Ter, Raleigh, NC 27610-5951 | 2019-01-05 |
| 1356813455 | Lamesha Marshall | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3335 Avalon Ave, Charlotte, NC 28208-3378 | 2018-12-31 |
| 1487131074 | Ronald Anthony Benjamin | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1594 Candace Ridge Dr, Greensboro, NC 27406-8595 | 2018-07-26 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.