BH Brightview South River Opco, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

BH BRIGHTVIEW SOUTH RIVER OPCO, LLC

Doing business as

Brightview South River

Practice address

8 Lee Airpark Drive
Edgewater, MD 21037

Phone

(410) 956-7310

Fax

(410) 956-7311

NPI assigned

Dec 12, 2019

Last updated

Nov 3, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Doug Dollenberg Jr.

Title

Authorized Signatory BH Brightview

Phone

(410) 962-0595

Specialties & licenses 2

Addresses

Other names 1

• Brightview South River Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1576108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604361600000",
    "number": "1033757786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 LEE AIRPARK DRIVE",
            "city": "EDGEWATER",
            "state": "MD",
            "postal_code": "21037",
            "telephone_number": "410-956-7310",
            "fax_number": "410-956-7311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 LEE AIRPARK DRIVE",
            "city": "EDGEWATER",
            "state": "MD",
            "postal_code": "21037",
            "telephone_number": "410-956-7310",
            "fax_number": "410-956-7311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BH BRIGHTVIEW SOUTH RIVER OPCO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-12",
        "last_updated": "2020-11-03",
        "certification_date": "2020-11-03",
        "status": "A",
        "authorized_official_last_name": "DOLLENBERG",
        "authorized_official_first_name": "DOUG",
        "authorized_official_title_or_position": "AUTHORIZED SIGNATORY BH BRIGHTVIEW",
        "authorized_official_telephone_number": "410-962-0595",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brightview South River",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Brightview South River",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Bayside Physical Therpay and Sports Rehabilitation, Inc
• Laurel Elaine Beall, OTRL
• Karly Johnson Beaty, M.S. CCC-SLP
• Karen S Beling, OD
• Lori Bennett, PT
• Courtney Bianchi, LCSW-C
• Kendall Blumenthal
• Maryann Boyle, LCSWC
• Lauren Simpson Braggins, SLP
• Nancy Branch, M.A., C.R.C.

• Assisted Living Facility in Edgewater, MD
• Providers in Edgewater, MD by specialty
• Assisted Living Facility in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.