Elijah Bradley
Individual provider Active NPI Day Training/Habilitation Specialist · Anchorage, AK
NPI 1083311286 · NPPES record last updated Feb 8, 2023
Key facts
- NPI
- 1083311286
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Day Training/Habilitation Specialist 373H00000X
- Practice address
- 1550 E 74TH Ave
Anchorage, AK 99507-2614 - Phone
- (907) 929-5826
- NPI assigned
- Feb 8, 2023
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Personal Care Attendant | 3747P1801X | |||
| Day Training/Habilitation Specialist | 373H00000X | AK | Yes |
Addresses
Primary practice location
1550 E 74TH Ave
Anchorage, AK 99507-2614
Mailing address
1550 E 74TH Ave
Anchorage, AK 99507-2614
Phone (907) 929-5826
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NA | Other | NA |
Other providers in Anchorage, AK
- John Edward Bradford
- Bradley House
- Andrew Bradley
- Carolyn Bradley
- Denisha Bradley
- Deandre' Antonio Bradshaw
- Deanna May Bradshaw
- Chester Upton Bradstreet
- Jeanne C Brady
- Patrick David Brady
All providers in Anchorage, AK · Day Training/Habilitation Specialist in Alaska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 8, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.