Healthcare Provider Details

I. General information

NPI: 1255156717
Provider Name (Legal Business Name): BROCK HEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2024
Last Update Date: 11/20/2024
Certification Date: 11/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

95 ACCESS HWY
LIMESTONE ME
04750-6300
US

IV. Provider business mailing address

4 WELLINGTON DR
ROCKPORT ME
04856-4019
US

V. Phone/Fax

Practice location:
  • Phone: 207-325-4771
  • Fax: 207-325-4239
Mailing address:
  • Phone: 207-691-5059
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: KELLY WESBROCK
Title or Position: OWNER
Credential:
Phone: 207-691-5059