- Enrollment id
- O20210618002207
- Enrollment state
- FL
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1184895740
- Multiple npi flag
- N
- Ccn
- 103174
- Associate id
- 9638238694
- Organization name
- BROOKS HOME CARE ADVANTAGE, INC.
- Doing business as name
- BROOKS REHABILIATION HOME HEALTH
- Incorporation date
- 2008-06-30
- Incorporation state
- FL
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- N
- Address line 1
- 6676 CORPORATE CENTER PKWY
- Address line 2
- STE 104
- City
- JACKSONVILLE
- State
- FL
- Zip code
- 322160108