Provider Demographics
NPI:1164135034
Name:BROOKSHIRE HEALTHCARE LLC
Entity Type:Organization
Organization Name:BROOKSHIRE HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EX VP AND GENERAL COUNSEL
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-447-9829
Mailing Address - Street 1:4660 E ASBURY CIR
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-4723
Mailing Address - Country:US
Mailing Address - Phone:303-756-1546
Mailing Address - Fax:
Practice Address - Street 1:4660 E ASBURY CIR
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-4723
Practice Address - Country:US
Practice Address - Phone:303-756-1546
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-05
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility