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Organization
BROOKHAVEN MS OPERATING LLC
Active
Organization
BROOKHAVEN MS OPERATING LLC
Active
Other names
Lincoln Residential Center
Organization subpart
No
Provider details
NPI number
Authorized official
MOISHE MAYER (AUTHORIZED SIGNATORY)
(718) 614-8341
Entity
Organization
Contact information
Practice address
524 BROOKMAN DR, BROOKHAVEN, MS 39601-2384
(601) 835-1884
Mailing address
710 OBRECHT RD, SYKESVILLE, MD 21784-7650
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Enumeration date
12/23/2024
Last updated
12/23/2024
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