Provider Demographics
NPI:1063020329
Name:BROOKE & SIMM INC.
Entity Type:Organization
Organization Name:BROOKE & SIMM INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINSTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:BROOKE
Authorized Official - Middle Name:A
Authorized Official - Last Name:SANASINH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-233-1643
Mailing Address - Street 1:7902 NATOMA ST
Mailing Address - Street 2:
Mailing Address - City:EASTVALE
Mailing Address - State:CA
Mailing Address - Zip Code:92880-3260
Mailing Address - Country:US
Mailing Address - Phone:949-233-1643
Mailing Address - Fax:951-479-5132
Practice Address - Street 1:6885 CEDAR CREEK RD
Practice Address - Street 2:
Practice Address - City:EASTVALE
Practice Address - State:CA
Practice Address - Zip Code:92880-8805
Practice Address - Country:US
Practice Address - Phone:951-520-1074
Practice Address - Fax:951-479-5132
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-22
Last Update Date:2020-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA336410692OtherRCFE