BROCKTON HEALTHCARE NETWORK (NPI# 1528200227) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528200227 |
| Entity Type | Organization |
| Organization Name | BROCKTON HEALTHCARE NETWORK |
| Practice Address |
5701 Spruce Tree Dr Columbus OH 43232-7751 |
| Practice Telephone | 6143676051 |
| Enumeration Date | 2009-03-27 |
| Last Update Date | 2009-03-27 |
| Authorized Official Name | MR. AUGUSTINE M. NORRIS (CEO) |
| Authorized Official Telephone | 6143676051 |
| Authorized Official Credential | MBA(MANAGEMENT) |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | SB612704 | OH | Residential Treatment Facilities |
| Street Address |
5701 SPRUCE TREE DR |
| City | COLUMBUS |
| State | OH |
| Zip Code | 43232-7751 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831739119 | Evina Emvoutou | Community Health Worker | 2166 Riverdale Square, Columbus, OH 43232 | 2020-01-14 |
| 1538712484 | Dominic Nchamukong | Nurse Practitioner | 4646 Hilton Corporate Dr, Columbus, OH 43232 | 2019-07-19 |
| 1871058602 | Angelique Jackson | Registered Nurse | 2376 Carlford Street, Columbus, OH 43232 | 2019-02-06 |
| 1033693569 | Mount Carmel Behavioral Healthcare, LLC | Psychiatric Hospital | 4646 Hilton Corporate Drive, Columbus, OH 43232 | 2018-09-20 |
| 1720500523 | Annie D Jordan | Home Health Aide | 5049 Gunston Dr, Columbus, OH 43232 | 2017-07-13 |
| 1750755286 | Stephanie Baker | Community Health Worker | 6127 Roselawn Ave, Columbus, OH 43232 | 2015-11-20 |
| 1982076527 | Nicole Allen | Licensed Practical Nurse | 2067 Prestwick Drive, Columbus, OH 43232 | 2015-10-22 |
| 1508255357 | Andrea Tarr | Licensed Practical Nurse | 2492 Daily Rd, Columbus, OH 43232 | 2015-01-16 |
| 1205240694 | Alemsege Berhe | Licensed Practical Nurse | 1841 Riverdale Rd, Cplumbus, OH 43232 | 2014-06-13 |
| 1386987048 | Mikeyla Burrs | Licensed Practical Nurse | 1622 Noe Bixby Rd Apt C, Columbus, OH 43232 | 2013-04-01 |
| Find all providers in zip 43232 | ||||
| Taxonomy Code | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548827751 | Pyramid House LLC | Community Based Residential Treatment Facility, Mental Illness | 6041 Mcnaughten Grove Ln, Columbus, OH 43213-5106 | 2019-05-22 |
| 1770066029 | New Beginnings PCh of Columbus, LLC | Community Based Residential Treatment Facility, Mental Illness | 639 Lawyers Ln, Columbus, GA 31906-3812 | 2018-09-12 |
| 1083067896 | Jaz Boyce | Community Based Residential Treatment Facility, Mental Illness | 592 Wiltshire Rd, Columbus, OH 43204-2429 | 2016-07-16 |
| 1679927974 | Parents Addressing Teen Challenges | Community Based Residential Treatment Facility, Mental Illness | 65 N Powell Ave, Columbus, OH 43204-2618 | 2016-04-22 |
| 1750840773 | Nationwide Residential Services | Community Based Residential Treatment Facility, Mental Illness | 1150 Morse Rd Ste 110, Columbus, OH 43229-6327 | 2019-03-19 |
| 1285119180 | Maryhaven | Community Based Residential Treatment Facility, Mental Illness | 100 Noe Bixby Rd, Columbus, OH 43213-1460 | 2018-09-27 |
| 1225580608 | Kamilah Muse | Community Based Residential Treatment Facility, Mental Illness | 765 Pierce Dr, Columbus, OH 43223-2425 | 2016-11-01 |
| 1346627460 | Kenneth B Walker Residential Home Inc | Community Based Residential Treatment Facility, Mental Illness | 3575 Macon Rd, Suite 25, Columbus, GA 31907-8200 | 2015-04-27 |
| 1972992816 | Alexia D. Faggins | Community Based Residential Treatment Facility, Mental Illness | 2100 Comer Ave, Columbus, GA 31904-8725 | 2015-01-15 |
| 1104214048 | The Village Network | Community Based Residential Treatment Facility, Mental Illness | 1751 E Long St, Columbus, OH 43203-2045 | 2014-12-30 |
| Find all providers in COLUMBUS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.