Basic Information
| Provider Information | |||||||||
| NPI: | 1700203890 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BROOKDALE HOME HEALTH, LLC | ||||||||
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| OtherOrganizationName: | BROOKDALE HOME HEALTH | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 111 WESTWOOD PL | ||||||||
| Address2: | STE 400 | ||||||||
| City: | BRENTWOOD | ||||||||
| State: | TN | ||||||||
| PostalCode: | 370275021 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6152212250 | ||||||||
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| Practice Location | |||||||||
| Address1: | 6737 W WASHINGTON ST | ||||||||
| Address2: | STE 1325 | ||||||||
| City: | MILWAUKEE | ||||||||
| State: | WI | ||||||||
| PostalCode: | 532145647 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4149185290 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/26/2014 | ||||||||
| LastUpdateDate: | 05/15/2014 | ||||||||
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| AuthorizedOfficialLastName: | MCGLASSON | ||||||||
| AuthorizedOfficialFirstName: | JULIE | ||||||||
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| AuthorizedOfficialTitleorPosition: | SR. DIRECTOR REGULATORY PRACTICES | ||||||||
| AuthorizedOfficialTelephone: | 6155648034 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251E00000X | Y | Agencies | Home Health |
No ID Information.