Provider Demographics
NPI:1346057098
Name:SAGE AND SWEETGRASS AT THE BRADSHAW HOUSE INC.
Entity type:Organization
Organization Name:SAGE AND SWEETGRASS AT THE BRADSHAW HOUSE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BELINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:DIXON-DAWSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-370-5924
Mailing Address - Street 1:420 MITCHELL ST N
Mailing Address - Street 2:
Mailing Address - City:AHOSKIE
Mailing Address - State:NC
Mailing Address - Zip Code:27910-2614
Mailing Address - Country:US
Mailing Address - Phone:252-370-5924
Mailing Address - Fax:
Practice Address - Street 1:420 MITCHELL ST N
Practice Address - Street 2:
Practice Address - City:AHOSKIE
Practice Address - State:NC
Practice Address - Zip Code:27910-2614
Practice Address - Country:US
Practice Address - Phone:252-370-5924
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-16
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes177F00000XOther Service ProvidersLodging