Gilead Therapy Professional Limited Liability Company | |
560 S State St Ste E1 Orem UT 84058-6347 | |
(801) 376-0566 | |
Not Available |
Full Name | Gilead Therapy Professional Limited Liability Company |
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Speciality | Social Worker |
Location | 560 S State St Ste E1, Orem, Utah |
Authorized Official Name and Position | Brooke Bradford (OWNER, LCSW) |
Authorized Official Contact | 8013760566 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Gilead Therapy Professional Limited Liability Company 1898 W 830 N Provo UT 84604-5946 Ph: () - | Gilead Therapy Professional Limited Liability Company 560 S State St Ste E1 Orem UT 84058-6347 Ph: (801) 376-0566 |
NPI Number | 1265180848 |
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Provider Enumeration Date | 03/14/2022 |
Last Update Date | 03/14/2022 |
Certification Date | 03/14/2022 |
Medicare PECOS PAC ID | 1759777394 |
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Medicare Enrollment ID | O20220406002556 |
Identifier | Type | State | Issuer |
---|---|---|---|
1265180848 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
Provider Name | Brooke Bradford |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1447609284 PECOS PAC ID: 2668868209 Enrollment ID: I20220406002603 |
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