Well BL Portfolio 1 Opco LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

WELL BL PORTFOLIO 1 OPCO LLC

Doing business as

Brandywine Living at Summit

Practice address

41 Springfield Ave
Summit, NJ 07901-4038

Phone

(908) 522-8852

Fax

(908) 522-8862

NPI assigned

Jan 29, 2021

Organization subpart

No

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

Authorized official

Name

Mrs. Jennifer Mahon

Title

Authorized Signatory

Phone

(856) 813-2000

Specialties & licenses 1

Addresses

Other names 1

• Brandywine Living at Summit Doing business as

Tax ID family

Brandywine Living at Summit2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Wellbl Portfolio 1 Opco LLC

  dba Brandywine Living Serenade at Princeton

  • Assisted Living Facility
  • Princeton, NJ
  • NPI 1265023527
  NPD tax ID

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

{
    "created_epoch": "1611878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612137600000",
    "number": "1033700380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 SPRINGFIELD AVE",
            "city": "SUMMIT",
            "state": "NJ",
            "postal_code": "079014038",
            "telephone_number": "908-522-8852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 SPRINGFIELD AVE",
            "city": "SUMMIT",
            "state": "NJ",
            "postal_code": "079014038",
            "telephone_number": "908-522-8852",
            "fax_number": "908-522-8862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELL BL PORTFOLIO 1 OPCO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-29",
        "last_updated": "2021-02-01",
        "certification_date": "2021-02-01",
        "status": "A",
        "authorized_official_last_name": "MAHON",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "AUTHORIZED SIGNATORY",
        "authorized_official_telephone_number": "856-813-2000",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brandywine Living at Summit",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lisa Michelle Weinman, M.S.,P.T.
• Jack Sanford Weinstein, MD
• James F Weiss, PHD
• Shannon B Welch, PT, DPT
• Well BL Opco LLC (Brandywine Living at Summit)
• John Andrew Werring, M.D.
• Cathy M. West, PH.D.
• Paula West
• Westfield Associates, PC
• Stephanie Marie Whitney, MS

• Assisted Living Facility in Summit, NJ
• Providers in Summit, NJ by specialty
• Assisted Living Facility in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2021; 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.