CDBR Enterprise LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

SNF15320961 Issued in FL

Legal business name

CDBR ENTERPRISE LLC

Doing business as

Braden River Care Center

Practice address

2010 Manatee Ave E
Bradenton, FL 34208-1560

Phone

(941) 747-3706

Fax

(941) 746-7785

NPI assigned

Sep 26, 2008

Organization subpart

No

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

Authorized official

Name

Mr. Christopher Grella, N/A

Title

Managing Member

Phone

(941) 747-3706

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Braden River Care Center Doing business as

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

{
    "created_epoch": "1222387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222387200000",
    "number": "1174773048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2010 MANATEE AVE E",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342081560",
            "telephone_number": "941-747-3706",
            "fax_number": "941-746-7785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 MANATEE AVE E",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342081560",
            "telephone_number": "941-747-3706",
            "fax_number": "941-746-7785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CDBR ENTERPRISE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-26",
        "last_updated": "2008-09-26",
        "status": "A",
        "authorized_official_last_name": "GRELLA",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "941-747-3706",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "N/A"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "FL",
            "license": "SNF15320961",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "026566700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Braden River Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Denis M Cavanagh, MD
• Kristen Cavanaugh, OTR/L
• Nicholas Michael Cavis, RPH
• CCRC Opco - Bradenton, LLC (The Nursing Center at Freedom Village)
• CCRC Opco - Bradenton, LLC (Nursing Center at Freedom Village)
• Jorge Enrique Ceballos I, DDS
• Nathalie Cecilia, LMT
• Miguel Angel Cedeno
• Arys Daniel Celaya, M.D.
• Veronica Elizabeth Celis

• Skilled Nursing Facility in Bradenton, FL
• Providers in Bradenton, FL by specialty
• Skilled Nursing Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2008; 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.