Provider Demographics
NPI:1073366381
Name:BROOKSBOYDLLC
Entity Type:Organization
Organization Name:BROOKSBOYDLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:CUBA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-277-5631
Mailing Address - Street 1:100 LAKEVIEW CT
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:VA
Mailing Address - Zip Code:22554-5099
Mailing Address - Country:US
Mailing Address - Phone:202-277-5631
Mailing Address - Fax:
Practice Address - Street 1:100 LAKEVIEW CT
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:VA
Practice Address - Zip Code:22554-5099
Practice Address - Country:US
Practice Address - Phone:202-277-5631
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-08
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care