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Contact Information

EASTBROOK CENTER LLC
3819 CHESTERFIELD AVE
CHARLESTON, WV25304-2647
 Phone: 304-925-4771
 Fax: 304-925-1343
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Skilled Nursing Facility

314000000X A1[8] Skilled Nursing Facility
 

Nursing Facility/Intermediate Care Facility

313M00000X A3[10] Other Nursing Facility
Indicates primary specialty

NPI Profile & details for EASTBROOK CENTER LLC

NPI # 1972936482
LBN Legal business name EASTBROOK CENTER LLC
Authorized official LAWRENCE PACK - (OWNER/MANAGER)
Entity Organization
Organization subpart 1 No
Enumeration date 08/20/2013
Last updated 05/18/2022 - About 4 years ago
Identifiers
WV License # 65
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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