Brooksville Assisted Living Home Inc.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

BROOKSVILLE ASSISTED LIVING HOME INC.

Practice address

55 Oakwood Dr
Brooksville, MS 39739-2004

Phone

(662) 738-4866

NPI assigned

Jul 7, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Aaron Koehn, RN

Title

Administrator

Phone

(662) 738-4866

Specialties & licenses 1

Addresses

Other names 1

• Oakwood Manor Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1625616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625616000000",
    "number": "1245801646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 OAKWOOD DR",
            "city": "BROOKSVILLE",
            "state": "MS",
            "postal_code": "397392004",
            "telephone_number": "662-738-4866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 OAKWOOD DR",
            "city": "BROOKSVILLE",
            "state": "MS",
            "postal_code": "397392004",
            "telephone_number": "662-738-4866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKSVILLE ASSISTED LIVING HOME INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-07",
        "last_updated": "2021-07-07",
        "certification_date": "2021-07-07",
        "status": "A",
        "authorized_official_last_name": "KOEHN",
        "authorized_official_first_name": "AARON",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "662-738-4866",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Oakwood Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ronald James Anthony Jr.
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• Brooksville Medical Clinic Inc
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• First Choice Family Medical Clinic, LLC

• Assisted Living Facility in Brooksville, MS
• Providers in Brooksville, MS by specialty
• Assisted Living Facility in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.