| Ann Marie Bradley Enterprises Inc | |
|
190 N Main St Plymouth MI 48170-1236 | |
| (734) 416-3341 | |
| (734) 416-3345 |
| Full Name | Ann Marie Bradley Enterprises Inc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 190 N Main St, Plymouth, Michigan |
| Authorized Official Name and Position | Shelley Taglione (BILLING CEO) |
| Authorized Official Contact | 7344140754 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ann Marie Bradley Enterprises Inc 190 N Main St Plymouth MI 48170-1236 Ph: (734) 416-3341 | Ann Marie Bradley Enterprises Inc 190 N Main St Plymouth MI 48170-1236 Ph: (734) 416-3341 |
| NPI Number | 1447510060 |
|---|---|
| Provider Enumeration Date | 05/17/2012 |
| Last Update Date | 05/17/2012 |
| Medicare PECOS PAC ID | 1759544760 |
|---|---|
| Medicare Enrollment ID | O20120531000105 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447510060 | NPI | - | NPPES |
| 8008911330 | Other | MI | BLUE CROSS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | AB059736 (Michigan) | Primary |
| Provider Name | Ann M Bradley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093862617 PECOS PAC ID: 6103089115 Enrollment ID: I20120531000135 |
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