Healthcare Provider Details

I. General information

NPI: 1699630616
Provider Name (Legal Business Name): RICHARD BROOKS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/22/2025
Last Update Date: 12/22/2025
Certification Date: 12/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4545 CONNECTICUT AVE NW APT 304
WASHINGTON DC
20008-6024
US

IV. Provider business mailing address

4545 CONNECTICUT AVE NW APT 304
WASHINGTON DC
20008-6024
US

V. Phone/Fax

Practice location:
  • Phone: 804-904-0873
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: