Provider Demographics
NPI:1578207346
Name:RC BROOKS CONSULTING LLC
Entity Type:Organization
Organization Name:RC BROOKS CONSULTING LLC
Other - Org Name:BLUEPRINT DIABETES MANAGEMENT & CONSULTING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RUSHICKAH
Authorized Official - Middle Name:
Authorized Official - Last Name:BROOKS
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:860-951-4140
Mailing Address - Street 1:14 HAZARD AVE STE 23
Mailing Address - Street 2:
Mailing Address - City:ENFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06082-3713
Mailing Address - Country:US
Mailing Address - Phone:860-951-4140
Mailing Address - Fax:860-300-8465
Practice Address - Street 1:11 TAVERNER RD
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:CT
Practice Address - Zip Code:06095-1749
Practice Address - Country:US
Practice Address - Phone:860-951-4140
Practice Address - Fax:860-300-8465
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-26
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No163WD0400XNursing Service ProvidersRegistered NurseDiabetes EducatorGroup - Multi-Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Multi-Specialty