Provider Demographics
NPI:1699180737
Name:BROOKE'S HOMECARE
Entity Type:Organization
Organization Name:BROOKE'S HOMECARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-655-3400
Mailing Address - Street 1:134 HEIGHTS RD
Mailing Address - Street 2:
Mailing Address - City:DARIEN
Mailing Address - State:CT
Mailing Address - Zip Code:06820-4119
Mailing Address - Country:US
Mailing Address - Phone:203-655-3400
Mailing Address - Fax:203-202-3510
Practice Address - Street 1:134 HEIGHTS RD
Practice Address - Street 2:
Practice Address - City:DARIEN
Practice Address - State:CT
Practice Address - Zip Code:06820-4119
Practice Address - Country:US
Practice Address - Phone:203-655-3400
Practice Address - Fax:203-202-3510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-27
Last Update Date:2014-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTHCA0000850251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health