Provider Demographics
NPI:1629795620
Name:MY BROTHER'S KEEPER HOME CARE, LLC
Entity Type:Organization
Organization Name:MY BROTHER'S KEEPER HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROSE
Authorized Official - Middle Name:MARIEA
Authorized Official - Last Name:WESLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-241-4363
Mailing Address - Street 1:213 SAINT NICHOLAS AVE
Mailing Address - Street 2:
Mailing Address - City:BREWTON
Mailing Address - State:AL
Mailing Address - Zip Code:36426-2063
Mailing Address - Country:US
Mailing Address - Phone:251-241-4363
Mailing Address - Fax:251-286-8049
Practice Address - Street 1:109 SAINT JOSEPH AVE STE 210
Practice Address - Street 2:
Practice Address - City:BREWTON
Practice Address - State:AL
Practice Address - Zip Code:36426-2055
Practice Address - Country:US
Practice Address - Phone:251-363-5100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-20
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care