Provider Demographics
NPI:1154812006
Name:BROOKBRIDGE HWSC LLC
Entity type:Organization
Organization Name:BROOKBRIDGE HWSC LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-422-2515
Mailing Address - Street 1:415 MANATEE AVE E
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34208-1143
Mailing Address - Country:US
Mailing Address - Phone:941-303-5642
Mailing Address - Fax:941-371-2172
Practice Address - Street 1:2650 BAHIA VISTA ST STE 204
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-2625
Practice Address - Country:US
Practice Address - Phone:941-303-5642
Practice Address - Fax:941-371-2172
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-27
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health