Organization
NINE PALMS 1, LLC
Active
Other names
Brookside Home Health, an Amedisys Company
Organization subpart
No
Provider details
NPI number
Authorized official
JOSHUA L. PROFFITT (PRESIDENT AND CEO)
(617) 639-4092
Entity
Organization
Contact information
Practice address
5360 DISCOVERY PARK BLVD STE 200, WILLIAMSBURG, VA 23188-2860
(757) 253-2536
(757) 253-8068
Mailing address
3854 AMERICAN WAY STE A, BATON ROUGE, LA 70816-4897
(225) 292-2031
(225) 295-9678
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
004971159
VA PRIEIMER HEALTH PLAN
VA
01
—
004971248
VA PRIEIMER HEALTH PLAN
VA
01
—
1851340
CIGNA
VA
01
—
19649
SENTARA HEALTH PLAN
VA
01
—
226349
MAMSI HEALTH PLANS
VA
01
—
236402
MAMSI
VA
01
—
299072
MAMSI HEALTH PLANS
VA
01
—
442171
BCBS VA ANTHEM
VA
01
—
442173
BCBS VA ANTHEM
VI
01
—
442175
BCBS VA ANTHEM
VA
01
—
442235
BCBS VA ANTHEM
VA
05
—
4971264
—
VA
01
—
5965078
AETNA US HEALTH CARE
VA
Enumeration date
05/23/2006
Last updated
03/20/2026
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