MEDICARE: LITTLE BROOK HOME INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility	061003	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1154372969
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LITTLE BROOK HOME INC.

Provider Business Mailing Address
First Line	:	PO BOX 398
Second Line	:
City	:	CALIFON
State	:	NJ
Zip	:	07830-0398
Country	:	US
Telephone Number	:	908-832-5265
Fax Number	:

Provider Business Practice Location Address
First Line	:	78 SLIKER RD
Second Line	:
City	:	CALIFON
State	:	NJ
Zip	:	07830-4178
Country	:	US
Telephone Number	:	908-832-2220
Fax Number	:	908-832-6626

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JOHN P HAMPILOS
Credential	:	PHD
Telephone Number	:	908-832-5265

Provider Enumeration Date	:	05/15/2006
Last Update Date	:	07/11/2025

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