# BREVARD HOME CARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** GRISWOLD HOMECARE
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316382385
- **Authorized official:** MR. VENKAT PUSKUR (OWNER)
- **Authorized official phone:** (321) 948-8555

## Contact information

- **Practice address:** 1600 SARNO RD, SUITE \# 119J, MELBOURNE, FL 32935-4938
- **Practice address phone:** (321) 948-8555
- **Mailing address:** 1185 TALON WAY, MELBOURNE, FL 32934-3257
- **Mailing address phone:** (321) 948-8555

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 05/06/2013
- **Last updated:** 05/06/2013