MEDICARE: BRENTWOOD HEALTH CARE

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	251E00000X	Home Health Agency	HP0100200	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	:	1619091857
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRENTWOOD HEALTH CARE

Provider Business Mailing Address
First Line	:	565 STATE ROUTE 35
Second Line	:	SUITE 3B
City	:	RED BANK
State	:	NJ
Zip	:	07701-5047
Country	:	US
Telephone Number	:	732-219-7080
Fax Number	:	732-219-7063

Provider Business Practice Location Address
First Line	:	565 STATE ROUTE 35
Second Line	:	SUITE 3B
City	:	RED BANK
State	:	NJ
Zip	:	07701-5047
Country	:	US
Telephone Number	:	732-219-7080
Fax Number	:	732-219-7063

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. JEFFREY COPELAND
Credential	:	CEO
Telephone Number	:	732-219-7080

Provider Enumeration Date	:	03/16/2007
Last Update Date	:	10/20/2014

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Directions to “BRENTWOOD HEALTH CARE ” Practice Location

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