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General NPI Number Information
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NPI Number | 1790758423
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Entity Type | Organization
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Legal Business Name | BROOKVILLE ENTERPRISES, INC.
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Dates
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Enumeration Date | 02/13/2006
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Last Update Date | 09/22/2025
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Provider Practice Location Address
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Address Line | 1 COUNTRY LN
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City | BROOKVILLE
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State | OH
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Zip | 45309-9269
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Country | US
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Telephone | 937-833-2133
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Fax |
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Provider Business Mailing Address
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Address Line | 1 COUNTRY LN
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City | BROOKVILLE
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State | OH
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Zip | 45309-9268
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Country | US
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Telephone | 937-833-2133
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Fax |
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Authorized Official
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Title or Position | OWNER/BOARD MEMBER
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Name | TERRY J MILLER
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Credential |
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Telephone | 937-477-0985
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 4590
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License Number State | OH
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