NPIMap

Organization Active NPI

Well BL Opco LLC

  • Assisted Living Facility
  • Watchung, NJ
National Provider Identifier
1104476241
Registry record updated Nov 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
WELL BL OPCO LLC
Practice address
680 Mountain Blvd
Watchung, NJ 07069-6270
Phone
(908) 754-8180
Fax
(908) 754-8184
NPI assigned
Sep 19, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2020

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

Authorized official

Name
Mr. Keith Phillips
Title
Authorized Signatory
Phone
(856) 813-2000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Primary

Addresses

Primary practice location

680 Mountain Blvd
Watchung, NJ 07069-6270

Mailing address

680 Mountain Blvd
Watchung, NJ 07069-6270
Phone (908) 754-8180

Other names 1

  • Brandywine Living at Mountain Ridge LLC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Brandywine Living at Brandall Estates LLC22 organizations share this tax ID, including this one

Other organizations with this tax ID 21

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

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1568851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605830400000",
    "number": "1104476241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 MOUNTAIN BLVD",
            "city": "WATCHUNG",
            "state": "NJ",
            "postal_code": "070696270",
            "telephone_number": "908-754-8180",
            "fax_number": "908-754-8184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 MOUNTAIN BLVD",
            "city": "WATCHUNG",
            "state": "NJ",
            "postal_code": "070696270",
            "telephone_number": "908-754-8180",
            "fax_number": "908-754-8184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELL BL OPCO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-19",
        "last_updated": "2020-11-20",
        "certification_date": "2020-11-20",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "KEITH",
        "authorized_official_title_or_position": "AUTHORIZED SIGNATORY",
        "authorized_official_telephone_number": "856-813-2000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brandywine Living at Mountain Ridge LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Watchung, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2020; 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.