National Provider Identifier Database

BROOKHAVEN MS OPERATING LLC
Intermediate Care Facility, Mentally Retarded

(1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals.


Contact Information

BROOKHAVEN MS OPERATING LLC
524 BROOKMAN DR
BROOKHAVEN, MS39601-2384
Phone: 601-835-1884
Fax:
Website:
Specialty Taxonomy Code
* Intermediate Care Facility, Mentally Retarded 315P00000X

* Indicates primary specialty

NPI Profile & details for BROOKHAVEN MS OPERATING LLC

NPI Number 1942018833
Legal business name
LBN
BROOKHAVEN MS OPERATING LLC
Authorized official MOISHE MAYER - (AUTHORIZED SIGNATORY)
Entity Organization
Organization subpart No
Enumeration date 12/23/2024
Last updated 12/23/2024 - More than a year ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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