Brooke Haven Care Home LLC

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

BROOKE HAVEN CARE HOME LLC

Practice address

1540 Berckmans Rd
Fort Worth, TX 76120-1500

Phone

(817) 308-1806

NPI assigned

Jun 13, 2018

Organization subpart

No

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

Authorized official

Name

Mr. Tyrin HoltNPI 1518471986

Title

Specialist

Phone

(817) 308-1806

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Brooke Haven Care Home Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tyrin W Holt

  • Specialist
  • Fort Worth, TX
  • NPI 1518471986
  NPD (past) Authorized official

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

{
    "created_epoch": "1528848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1417440488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4009 COTTAGE PARK CT",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760138087",
            "telephone_number": "817-308-1806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1540 BERCKMANS RD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761201500",
            "telephone_number": "817-308-1806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKE HAVEN CARE HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-13",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "HOLT",
        "authorized_official_first_name": "TYRIN",
        "authorized_official_title_or_position": "SPECIALIST",
        "authorized_official_telephone_number": "817-308-1806",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1518471986",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brooke Haven Care Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rose Marie Brockman, LCSW
• Stephen Gatlin Brogdon, DDS
• Harshal Sunil Broker, MD
• Bronson Clinic, Inc.
• Ross Morgan Bronson, DC
• Alexandra Brookman
• Penny Marie Brookover, GNP
• Brooks Memorial Clinic Fort Worth
• Brooks Psychological, PLLC
• Brooks Surgery Clinic, PLLC

• Specialist in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Specialist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.