Organization
BROOKS MANOR LLC
Active
Organization
BROOKS MANOR LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEVINDRA PERSAUD (MGR)
(772) 607-3858
Entity
Organization
Contact information
Practice address
2043 SE WATERCREST ST, PORT ST LUCIE, FL 34984-4768
(772) 607-3858
Mailing address
2043 SE WATERCREST ST, PORT ST LUCIE, FL 34984-4768
(772) 607-3858
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
—
—
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
Primary
—
—
311Z00000X
Custodial Care Facility
—
—
Other
Enumeration date
02/10/2023
Last updated
04/09/2024
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