Provider Demographics
NPI:1740430388
Name:BROWN RESIDENTIAL SUPPORT SERVICES INC
Entity Type:Organization
Organization Name:BROWN RESIDENTIAL SUPPORT SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:C
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:704-391-5588
Mailing Address - Street 1:5523 WINDY VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28208-1191
Mailing Address - Country:US
Mailing Address - Phone:704-391-5588
Mailing Address - Fax:704-391-5588
Practice Address - Street 1:5523 WINDY VALLEY DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28208-1191
Practice Address - Country:US
Practice Address - Phone:704-391-5588
Practice Address - Fax:704-391-5588
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-19
Last Update Date:2008-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home