Individual
BRICKNEY HENRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
652 NINE OAKS CIR, VILLA RICA, GA 30180-2533
(516) 497-8012
Mailing address
652 NINE OAKS CIR, VILLA RICA, GA 30180-2533
(516) 497-8012
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
251J00000X
Nursing Care Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
08/21/2019
Last updated
12/18/2020
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