Provider Demographics
NPI:1356712251
Name:BROOKS FAMILY HEALTH SERVICES LLC,
Entity type:Organization
Organization Name:BROOKS FAMILY HEALTH SERVICES LLC,
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:CHANTEL
Authorized Official - Middle Name:R
Authorized Official - Last Name:BROOKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-559-9356
Mailing Address - Street 1:46 BARTLEY AVE
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44906-3144
Mailing Address - Country:US
Mailing Address - Phone:419-559-9356
Mailing Address - Fax:
Practice Address - Street 1:46 BARTLEY AVE
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44906-3144
Practice Address - Country:US
Practice Address - Phone:419-559-9356
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-18
Last Update Date:2015-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health