Healthcare Provider Details

I. General information

NPI: 1154372969
Provider Name (Legal Business Name): LITTLE BROOK HOME INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2006
Last Update Date: 07/11/2025
Certification Date: 07/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

78 SLIKER RD
CALIFON NJ
07830-4178
US

IV. Provider business mailing address

PO BOX 398
CALIFON NJ
07830-0398
US

V. Phone/Fax

Practice location:
  • Phone: 908-832-2220
  • Fax: 908-832-6626
Mailing address:
  • Phone: 908-832-5265
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number061003
License Number StateNJ

VIII. Authorized Official

Name: DR. JOHN P HAMPILOS
Title or Position: OWNER
Credential: PHD
Phone: 908-832-5265