| Brady's Youth & Development Center | |
|
4048 Forest Dr. Columbia SC 29201 | |
| (704) 555-6235 | |
| Not Available |
| Full Name | Brady's Youth & Development Center |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 4048 Forest Dr., Columbia, South Carolina |
| Authorized Official Name and Position | Johnny Leroy Brady (CEO) |
| Authorized Official Contact | 7044978902 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brady's Youth & Development Center 4048 Forest Dr. Columbia SC 29201 Ph: () - | Brady's Youth & Development Center 4048 Forest Dr. Columbia SC 29201 Ph: (704) 555-6235 |
| NPI Number | 1043608250 |
|---|---|
| Provider Enumeration Date | 12/23/2014 |
| Last Update Date | 12/23/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043608250 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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