Organization
BROOKE HAVEN CARE HOME LLC
Active
Other names
Brooke Haven Care Home
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TYRIN HOLT (SPECIALIST)
(817) 308-1806
Entity
Organization
Contact information
Practice address
1540 BERCKMANS RD, FORT WORTH, TX 76120-1500
(817) 308-1806
Mailing address
4009 COTTAGE PARK CT, ARLINGTON, TX 76013-8087
(817) 308-1806
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1518471986
NPI
TX
Enumeration date
06/13/2018
Last updated
07/21/2022
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