Bradford Recovery Center

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

597030 Issued in PA

Legal business name

BRADFORD RECOVERY CENTER

Practice address

64 School St
Millerton, PA 16936-7768

Phone

(570) 537-6035

Fax

(570) 537-6038

NPI assigned

Mar 23, 2016

Last updated

Jan 28, 2019By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Bradley K Leib

Title

Ceo

Phone

(570) 537-6035

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1458691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548633600000",
    "number": "1063874568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64 SCHOOL ST",
            "city": "MILLERTON",
            "state": "PA",
            "postal_code": "169367768",
            "telephone_number": "570-537-6035",
            "fax_number": "570-537-6038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 SCHOOL ST",
            "city": "MILLERTON",
            "state": "PA",
            "postal_code": "169367768",
            "telephone_number": "570-537-6035",
            "fax_number": "570-537-6038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRADFORD RECOVERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-23",
        "last_updated": "2019-01-28",
        "status": "A",
        "authorized_official_last_name": "LEIB",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "570-537-6035",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "PA",
            "license": "597030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Martha Lloyd CRF Fla Millerton
• Millerton Acquistion Sub, LLC (Bradford Recovery Center)
• Zachary Wayne Wanner, PT, DPT

• Substance Abuse Rehabilitation Facility in Millerton, PA
• Providers in Millerton, PA by specialty
• Substance Abuse Rehabilitation Facility in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.