Provider Demographics
NPI:1568634962
Name:BROOKS HOME CARE SERVICES INC
Entity Type:Organization
Organization Name:BROOKS HOME CARE SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LILLIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ODIACHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-774-9463
Mailing Address - Street 1:9304 FOREST LN STE N165A
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-6238
Mailing Address - Country:US
Mailing Address - Phone:214-774-9463
Mailing Address - Fax:972-382-5559
Practice Address - Street 1:9304 FOREST LN STE N165A
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-6238
Practice Address - Country:US
Practice Address - Phone:214-774-9463
Practice Address - Fax:972-382-5559
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-26
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Multi-Specialty
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX74-7488Medicare PIN
TX=========Medicare PIN