Provider Demographics
NPI:1013044668
Name:BROOKLAND SENIOR DAY CARE CENTER, INC.
Entity type:Organization
Organization Name:BROOKLAND SENIOR DAY CARE CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:JANET
Authorized Official - Middle Name:S
Authorized Official - Last Name:BRAME
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-270-6261
Mailing Address - Street 1:PO BOX 60183
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20039-0183
Mailing Address - Country:US
Mailing Address - Phone:202-291-2173
Mailing Address - Fax:202-291-1085
Practice Address - Street 1:6210 CHILLUM PL NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-1400
Practice Address - Country:US
Practice Address - Phone:202-716-5667
Practice Address - Fax:202-722-8518
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2020-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QD1600X
DC261QA0600X261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC026075800Medicaid
DC034788207Medicaid