Provider Demographics
NPI:1023618808
Name:WELLBROOK RECOVERY BROOKFIELD LLC
Entity type:Organization
Organization Name:WELLBROOK RECOVERY BROOKFIELD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MEIR
Authorized Official - Middle Name:
Authorized Official - Last Name:KASNEET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-372-6643
Mailing Address - Street 1:13850 WEST CAPITOL DRIVE WELLBROOK RECOVERY
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53005
Mailing Address - Country:US
Mailing Address - Phone:414-356-1418
Mailing Address - Fax:414-409-5150
Practice Address - Street 1:13850 WEST CAPITOL DRIVE WELLBROOK RECOVERY
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53005
Practice Address - Country:US
Practice Address - Phone:414-867-9579
Practice Address - Fax:414-409-5150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-29
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilityGroup - Multi-Specialty
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty