Individual
EPHESUS BROOKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2801 PENNINGTON RD, HENRICO, VA 23294-4013
(804) 418-7999
Mailing address
4445 CORPORATION LN, VIRGINIA BEACH, VA 23462-3262
(804) 972-1132
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
171W00000X
Contractor
—
—
172A00000X
Driver
T67133866
VA
226000000X
Recreational Therapist Assistant
—
—
247000000X
Health Information Technician
—
—
3747P1801X
Personal Care Attendant
—
—
374U00000X
Home Health Aide
—
—
Other
Enumeration date
09/26/2023
Last updated
10/06/2023
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