Brookhaven Assisted Living LLC

Primary specialty

Custodial Care FacilityTaxonomy code 311Z00000X

Legal business name

BROOKHAVEN ASSISTED LIVING LLC

Practice address

19 W Main St
West Brookfield, MA 01585-2823

Phone

(508) 867-3325

NPI assigned

Aug 14, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Waqar Tajuddin

Title

Administrator

Phone

(617) 306-1900

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1565740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1565740800000",
    "number": "1003462276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 W MAIN ST",
            "city": "WEST BROOKFIELD",
            "state": "MA",
            "postal_code": "015852823",
            "telephone_number": "617-306-1900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 W MAIN ST",
            "city": "WEST BROOKFIELD",
            "state": "MA",
            "postal_code": "015852823",
            "telephone_number": "508-867-3325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKHAVEN ASSISTED LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-14",
        "last_updated": "2019-08-14",
        "status": "A",
        "authorized_official_last_name": "TAJUDDIN",
        "authorized_official_first_name": "WAQAR",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "617-306-1900"
    },
    "taxonomies": [
        {
            "code": "311Z00000X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacob Bedard, DPT
• Anne Blake, LMHC, LADC
• Shirley Anne Blanchard, COTA/L
• Meagan Blodgett, MS, OTR/L
• Kaitlyn Bonneau, MS
• Thomas Francis Cahill, DDS
• Keryth Evalyn Cargill, L.I.C.S.W.
• Central Mass Home Care LLC
• Henry H Christiansen, LICSW
• Nancy Ellen Currie, MSW; LICSW

• Custodial Care Facility in West Brookfield, MA
• Providers in West Brookfield, MA by specialty
• Custodial Care Facility in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.