Provider Demographics
NPI:1982118170
Name:BROOKS HOME CARE ADVANTAGE, INC.
Entity Type:Organization
Organization Name:BROOKS HOME CARE ADVANTAGE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF MANAGED CARE
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:SHRYOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-345-7606
Mailing Address - Street 1:5836 RICHARD ST
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-5925
Mailing Address - Country:US
Mailing Address - Phone:904-722-1515
Mailing Address - Fax:
Practice Address - Street 1:6871 BELFORT OAKS PL
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-6242
Practice Address - Country:US
Practice Address - Phone:904-722-1515
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BROOKS HOME CARE ADVANTAGE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-11-27
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health