Healthcare Provider Details

I. General information

NPI: 1851397590
Provider Name (Legal Business Name): BRETHREN CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 CENTER ST
ASHLAND OH
44805-4325
US

IV. Provider business mailing address

2000 CENTER ST
ASHLAND OH
44805-4325
US

V. Phone/Fax

Practice location:
  • Phone: 419-286-1585
  • Fax: 419-289-0715
Mailing address:
  • Phone: 419-286-1585
  • Fax: 419-289-0715

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number3219
License Number StateOH

VIII. Authorized Official

Name: MR. JAY WARREN BROOKS
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 419-289-1585