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General NPI Number Information
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NPI Number | 1396546925
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Entity Type | Organization
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Legal Business Name | BROOKWAY THERAPY AT HOME LLC
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Dates
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Enumeration Date | 03/20/2025
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Last Update Date | 03/20/2025
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Provider Practice Location Address
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Address Line | 1 BROOKWAY CT
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City | MANSFIELD
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State | TX
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Zip | 76063-5416
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Country | US
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Telephone | 817-307-0207
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Fax |
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Provider Business Mailing Address
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Address Line | 1 BROOKWAY CT
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City | MANSFIELD
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State | TX
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Zip | 76063-5416
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Country | US
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Telephone | 817-307-0207
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. DANA L CARR
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Credential | PT
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Telephone | 817-307-0207
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0401X
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Taxonomy Name | Comprehensive Outpatient Rehabilitation Facility (CORF)
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License Number |
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License Number State |
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