Healthcare Provider Details

I. General information

NPI: 1669831079
Provider Name (Legal Business Name): BROOKS SKILLED NURSING FACILITY A, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2016
Last Update Date: 12/23/2025
Certification Date: 12/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6210 BEACH BLVD
JACKSONVILLE FL
32216-2706
US

IV. Provider business mailing address

3599 UNIVERSITY BLVD S ATTN: MANAGED CARE
JACKSONVILLE FL
32216-4252
US

V. Phone/Fax

Practice location:
  • Phone: 904-345-8100
  • Fax: 904-345-8108
Mailing address:
  • Phone: 904-345-7291
  • Fax: 904-345-7284

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberSNF1149095
License Number StateFL

VIII. Authorized Official

Name: JENI ALLEN
Title or Position: DIRECTOR OF MANAGED CARE
Credential:
Phone: 904-345-7158