Provider Demographics
NPI:1134455595
Name:BRENTWOOD HOME HEALTHCARE SERVICES, INC.
Entity type:Organization
Organization Name:BRENTWOOD HOME HEALTHCARE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:BRENT
Authorized Official - Last Name:CLASSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-468-2273
Mailing Address - Street 1:907 W AURORA RD
Mailing Address - Street 2:
Mailing Address - City:SAGAMORE HILLS
Mailing Address - State:OH
Mailing Address - Zip Code:44067-1605
Mailing Address - Country:US
Mailing Address - Phone:330-468-2273
Mailing Address - Fax:330-468-0753
Practice Address - Street 1:907 W AURORA RD
Practice Address - Street 2:
Practice Address - City:SAGAMORE HILLS
Practice Address - State:OH
Practice Address - Zip Code:44067-1605
Practice Address - Country:US
Practice Address - Phone:330-468-2273
Practice Address - Fax:330-468-0753
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-20
Last Update Date:2009-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health