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PROVIDER DEMOGRAPHIC INFORMATION Supporting line for group header


Name:	BROMACK LLC
Address:	PO BOX 13725 READING, PA 19612-3725
Phone:	(610) 376-2639
E-mail:	BPControlService@gmail.com
Web Site:	N/A

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PROVIDER CERTIFICATION INFORMATION Supporting line for group header

Click here to view Provider Certification Information

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PROVIDER'S PARENT/ REGIONAL OFFICE Supporting line for group header


Type:	Corporate Office
Name:	BROMACK LLC
Address:	1401 N 13TH ST READING, PA 19604-1834
Phone:	(610) 376-2639

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PROVIDER SERVICES AND RATES Supporting line for group header


County : Berks
\|Service Name / Level	\|Rate

CPS Community 1:1	$12.81 / 15 min.
CPS Community 1:1 Enhanced	$17.83 / 15 min.
CPS Community 1:1 Enhcd LPN	$17.83 / 15 min.
CPS Community 1:1 Enhcd RN	$17.83 / 15 min.
CPS Community 1:2 or 1:3	$6.98 / 15 min.
CPS Community 2:1	$24.62 / 15 min.
CPS Community 2:1 Enhanced	$29.70 / 15 min.
CPS Community 2:1 Enhcd LPN	$29.70 / 15 min.
CPS Community 2:1 Enhcd RN	$29.70 / 15 min.
CPS Community 2:3	$10.43 / 15 min.
CPS: Community OnCall/Remote Support	$1.64 / 15 min.
Res Hab-1 Person-NG 1-Elig	$523.00 / 1 Day
Res Hab-1 Person-NG 1-Elig-w/Day Supports	$408.54 / 1 Day
Res Hab-1 Person-NG 2-Elig	$606.92 / 1 Day
Res Hab-1 Person-NG 2-Elig-w/Day Supports	$515.01 / 1 Day
Res Hab-1 Person-NG 3-Elig	$924.89 / 1 Day
Res Hab-1 Person-NG 3-Elig-w/Day Supports	$746.22 / 1 Day
Res Hab-1 Person-NG 4-Elig	$1,118.74 / 1 Day
Res Hab-1 Person-NG 4-Elig-w/Day Supports	$822.23 / 1 Day
Res Hab-2 Person-NG 1-Elig	$523.00 / 1 Day
Res Hab-2 Person-NG 1-Elig-w/Day Supports	$408.54 / 1 Day
Res Hab-2 Person-NG 2-Elig	$606.92 / 1 Day
Res Hab-2 Person-NG 2-Elig-w/Day Supports	$515.01 / 1 Day
Res Hab-2 Person-NG 3-Elig	$685.68 / 1 Day
Res Hab-2 Person-NG 3-Elig-w/Day Supports	$630.70 / 1 Day
Res Hab-2 Person-NG 4-Elig	$820.15 / 1 Day
Res Hab-2 Person-NG 4-Elig-w/Day Supports	$689.49 / 1 Day
Res Hab-3 Person-NG 4-Elig	$624.74 / 1 Day
Res Hab-3 Person-NG 4-Elig-w/Day Supports	$484.03 / 1 Day
Res Hab-Lic-1 Person-Inelig	$88.34 / 1 Day
Res Hab-Lic-2 Person-Inelig	$47.38 / 1 Day
Res Hab-Lic-3 Person-Inelig	$33.46 / 1 Day
Respit-Life Sharing-Day(Lvl 4, 2:1 Enh)InHome LPN	$661.90 / 1 Day
Respit-Life Sharing-Day(Lvl3,1:1 Enh)OutOfHome-LPN	$416.93 / 1 Day
Respit-Life Sharing-Day(Lvl4,2:1 Enh)OutOfHome LPN	$661.90 / 1 Day
Respite-Lic-Day-1 person-NG 3	$855.36 / 1 Day
Respite-Lic-Day-1 person-NG 3-Emergency	$855.36 / 1 Day
Respite-Lic-Day-1 person-NG 4	$931.37 / 1 Day
Respite-Lic-Day-1 person-NG 4-Emergency	$931.37 / 1 Day
Respite-Lic-Day-2 person-NG 1-Emergency	$474.70 / 1 Day
Respite-Lic-Day-2 person-NG 2	$581.17 / 1 Day
Respite-Lic-Day-2 person-NG 2-Emergency	$581.17 / 1 Day
Respite-Lic-Day-2 person-NG 3	$696.86 / 1 Day
Respite-Lic-Day-2 person-NG 3-Emergency	$696.86 / 1 Day
Respite-Lic-Day-2 person-NG 4	$755.65 / 1 Day
Respite-Lic-Day-2 person-NG 4-Emergency	$755.65 / 1 Day
Respite-Lic-Day-2 person-NG1	$474.70 / 1 Day
Respite-Lic-Day-3 person-NG 1	$348.80 / 1 Day
Respite-Lic-Day-3 person-NG 1-Emergency	$348.80 / 1 Day
Respite-Lic-Day-3 person-NG 2	$395.52 / 1 Day
Respite-Lic-Day-3 person-NG 2-Emergency	$395.52 / 1 Day
Respite-Lic-Day-3 person-NG 3	$495.21 / 1 Day
Respite-Lic-Day-3 person-NG 3-Emergency	$495.21 / 1 Day
Respite-Lic-Day-3 person-NG 4	$538.34 / 1 Day
Respite-Lic-Day-3 person-NG 4-Emergency	$538.34 / 1 Day
Respite-Life Sharing-Day (Level 2, 1:2) In-Home	$139.56 / 1 Day
Respite-Life Sharing-Day (Level 3, 1:1) In-Home	$245.13 / 1 Day
Respite-Life Sharing-Day (Level 3,1:1 Enh) In-Home	$416.93 / 1 Day
Respite-Life Sharing-Day (Level 4, 2:1 Enh)In-Home	$661.90 / 1 Day
Respite-Life Sharing-Day (Level 4, 2:1) In-Home	$490.11 / 1 Day
Respite-Life Sharing-Day(Level 4,2:1 Enh)InHome-RN	$661.90 / 1 Day
Respite-Life Sharing-Day(Lvl 3, 1:1 Enh)InHome LPN	$416.93 / 1 Day
Respite-Life Sharing-Day(Lvl 3, 1:1 Enh)InHome-RN	$416.93 / 1 Day
Respite-Unlic-Day (Basic 1:4) In-Home	$90.59 / 1 Day
Respite-Unlic-Day (Level 1, 1:3) In-Home	$119.11 / 1 Day
Respite-Unlic-Day (Level 2, 1:2) In-Home	$176.17 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) In-Home	$491.89 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) In-Home - TD	$491.89 / 1 Day
Respite-Unlic-Day (Level 3, 1:1 Enh) In-Home - TE	$491.89 / 1 Day
Respite-Unlic-Day (Level 3, 1:1) In-Home	$317.80 / 1 Day
Respite-Unlic-Day (Level 4, 2:1 Enh) In-Home - TD	$805.07 / 1 Day
Respite-Unlic-Day (Level 4, 2:1 Enh) In-Home - TE	$805.07 / 1 Day
Respite-Unlic-Day (Level 4, 2:1 Enhcd) In-Home	$805.07 / 1 Day
Respite-Unlic-Day (Level 4, 2:1) In-Home	$630.98 / 1 Day
Supplemental Habilitation 1:1 - 15 min	$5.77 / 15 min.
Supplemental Habilitation 2:1 - 15 min	$11.53 / 15 min.

County : Lancaster
\|Service Name / Level	\|Rate

Res Hab-1 Person-NG 1-Elig	$523.00 / 1 Day
Res Hab-1 Person-NG 1-Elig-w/Day Supports	$408.54 / 1 Day
Res Hab-1 Person-NG 2-Elig	$606.92 / 1 Day
Res Hab-1 Person-NG 2-Elig-w/Day Supports	$515.01 / 1 Day
Res Hab-1 Person-NG 3-Elig	$924.89 / 1 Day
Res Hab-1 Person-NG 3-Elig-w/Day Supports	$746.22 / 1 Day
Res Hab-1 Person-NG 4-Elig	$1,118.74 / 1 Day
Res Hab-1 Person-NG 4-Elig-w/Day Supports	$822.23 / 1 Day
Res Hab-2 Person-NG 1-Elig	$523.00 / 1 Day
Res Hab-2 Person-NG 1-Elig-w/Day Supports	$408.54 / 1 Day
Res Hab-2 Person-NG 2-Elig	$606.92 / 1 Day
Res Hab-2 Person-NG 2-Elig-w/Day Supports	$515.01 / 1 Day
Res Hab-2 Person-NG 3-Elig	$685.68 / 1 Day
Res Hab-2 Person-NG 3-Elig-w/Day Supports	$630.70 / 1 Day
Res Hab-2 Person-NG 4-Elig	$820.15 / 1 Day
Res Hab-2 Person-NG 4-Elig-w/Day Supports	$689.49 / 1 Day
Supplemental Habilitation 1:1 - 15 min	$5.77 / 15 min.
Supplemental Habilitation 2:1 - 15 min	$11.53 / 15 min.

County : Lebanon
\|Service Name / Level	\|Rate

Res Hab-1 Person-NG 1-Elig	$523.00 / 1 Day
Res Hab-1 Person-NG 1-Elig-w/Day Supports	$408.54 / 1 Day
Res Hab-1 Person-NG 2-Elig	$606.92 / 1 Day
Res Hab-1 Person-NG 2-Elig-w/Day Supports	$515.01 / 1 Day
Res Hab-1 Person-NG 3-Elig	$924.89 / 1 Day
Res Hab-1 Person-NG 3-Elig-w/Day Supports	$746.22 / 1 Day
Res Hab-1 Person-NG 4-Elig	$1,118.74 / 1 Day
Res Hab-1 Person-NG 4-Elig-w/Day Supports	$822.23 / 1 Day
Res Hab-2 Person-NG 1-Elig	$523.00 / 1 Day
Res Hab-2 Person-NG 1-Elig-w/Day Supports	$408.54 / 1 Day
Res Hab-2 Person-NG 2-Elig	$606.92 / 1 Day
Res Hab-2 Person-NG 2-Elig-w/Day Supports	$515.01 / 1 Day
Res Hab-2 Person-NG 3-Elig	$685.68 / 1 Day
Res Hab-2 Person-NG 3-Elig-w/Day Supports	$630.70 / 1 Day
Res Hab-2 Person-NG 4-Elig	$820.15 / 1 Day
Res Hab-2 Person-NG 4-Elig-w/Day Supports	$689.49 / 1 Day
Supplemental Habilitation 1:1 - 15 min	$5.77 / 15 min.
Supplemental Habilitation 2:1 - 15 min	$11.53 / 15 min.

County : Lehigh
\|Service Name / Level	\|Rate

CPS Community 1:1	$12.81 / 15 min.
CPS Community 1:1 Enhanced	$17.83 / 15 min.
CPS Community 1:1 Enhcd LPN	$17.83 / 15 min.
CPS Community 1:1 Enhcd RN	$17.83 / 15 min.
CPS: Community OnCall/Remote Support	$1.64 / 15 min.
Res Hab-1 Person-NG 1-Elig	$523.00 / 1 Day
Res Hab-1 Person-NG 1-Elig-w/Day Supports	$408.54 / 1 Day
Res Hab-1 Person-NG 2-Elig	$606.92 / 1 Day
Res Hab-1 Person-NG 2-Elig-w/Day Supports	$515.01 / 1 Day
Res Hab-1 Person-NG 3-Elig	$924.89 / 1 Day
Res Hab-1 Person-NG 3-Elig-w/Day Supports	$746.22 / 1 Day
Res Hab-1 Person-NG 4-Elig	$1,118.74 / 1 Day
Res Hab-1 Person-NG 4-Elig-w/Day Supports	$822.23 / 1 Day
Res Hab-2 Person-NG 1-Elig	$523.00 / 1 Day
Res Hab-2 Person-NG 1-Elig-w/Day Supports	$408.54 / 1 Day
Res Hab-2 Person-NG 2-Elig	$606.92 / 1 Day
Res Hab-2 Person-NG 2-Elig-w/Day Supports	$515.01 / 1 Day
Res Hab-2 Person-NG 3-Elig	$685.68 / 1 Day
Res Hab-2 Person-NG 3-Elig-w/Day Supports	$630.70 / 1 Day
Res Hab-2 Person-NG 4-Elig	$820.15 / 1 Day
Res Hab-2 Person-NG 4-Elig-w/Day Supports	$689.49 / 1 Day
Res Hab-Lic-2 Person-Inelig	$47.38 / 1 Day
Supplemental Habilitation 1:1 - 15 min	$5.77 / 15 min.
Supplemental Habilitation 2:1 - 15 min	$11.53 / 15 min.

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