MEDICARE: THE BROOK WELLNESS CENTER, 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	101YA0400X	Addiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number	:	1467008599
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE BROOK WELLNESS CENTER, INC

Provider Business Mailing Address
First Line	:	PO BOX 826
Second Line	:
City	:	BRANSON
State	:	MO
Zip	:	65615-0826
Country	:	US
Telephone Number	:	417-527-8877
Fax Number	:

Provider Business Practice Location Address
First Line	:	11016 E STATE HIGHWAY 76
Second Line	:
City	:	BRANSON WEST
State	:	MO
Zip	:	65737-9775
Country	:	US
Telephone Number	:	417-527-8877
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ROSE MARY ROBINSON
Credential	:
Telephone Number	:	417-527-8877

Provider Enumeration Date	:	08/14/2019
Last Update Date	:	10/20/2023

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