Provider Demographics
NPI:1407615107
Name:BROOKS HOSPICE GROUP LLC
Entity Type:Organization
Organization Name:BROOKS HOSPICE GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:AUDREY
Authorized Official - Middle Name:
Authorized Official - Last Name:NEWTONE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:917-941-1046
Mailing Address - Street 1:5702 FREEPORT LEAF
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78253-4474
Mailing Address - Country:US
Mailing Address - Phone:210-255-8254
Mailing Address - Fax:210-255-8834
Practice Address - Street 1:5702 FREEPORT LEAF
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78253-4474
Practice Address - Country:US
Practice Address - Phone:210-255-8254
Practice Address - Fax:210-255-8834
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-15
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH1000XNursing Service ProvidersRegistered NurseHospiceGroup - Single Specialty