Healthcare Provider Details

I. General information

NPI: 1578077731
Provider Name (Legal Business Name): BROOKS HOME CARE ADVANTAGE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/27/2017
Last Update Date: 12/23/2025
Certification Date: 12/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3424 SAINT JOHNS AVE
PALATKA FL
32177-4020
US

IV. Provider business mailing address

6676 CORPORATE CENTER PKWY STE 104
JACKSONVILLE FL
32216-0108
US

V. Phone/Fax

Practice location:
  • Phone: 386-325-4567
  • Fax:
Mailing address:
  • Phone: 904-722-1515
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

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