NPIMap

Organization Active NPI

Brea Decatur LLC

  • Assisted Living Facility
  • Decatur, GA
National Provider Identifier
1174859904
Registry record updated Oct 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
044-03-241 Issued in GA
Legal business name
BREA DECATUR LLC
Practice address
475 Irvin CT
Decatur, GA 30030-1717
Phone
(404) 299-6600
NPI assigned
Oct 29, 2009
Organization subpart
Yes
Parent organization
BREA EMERITUS LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 29, 2009

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

Authorized official

Name
Noelle Bickel
Title
Licensing Specialist
Phone
(206) 298-2909

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 044-03-241 GA Primary
Alzheimer Center (Dementia Center) 311500000X 044-03-241 GA

Addresses

Primary practice location

475 Irvin CT
Decatur, GA 30030-1717

Mailing address

3131 Elliott Ave Ste 500
Seattle, WA 98121-1032

Other names 1

  • Court at Decatur Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Brea Charlotte LLC25 organizations share this tax ID, including this one
Part of
Brea Charlotte LLC

Other organizations with this tax ID 24

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

View all 24

Locations

475 Irvin Ct
Decatur, GA 30030
Phone (404) 299-1581

NPI Registry JSON

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

{
    "created_epoch": "1256774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1256774400000",
    "number": "1174859904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3131 ELLIOTT AVE STE 500",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981211032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 IRVIN CT",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300301717",
            "telephone_number": "404-299-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BREA DECATUR LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BREA EMERITUS LLC",
        "enumeration_date": "2009-10-29",
        "last_updated": "2009-10-29",
        "status": "A",
        "authorized_official_last_name": "BICKEL",
        "authorized_official_first_name": "NOELLE",
        "authorized_official_title_or_position": "LICENSING SPECIALIST",
        "authorized_official_telephone_number": "206-298-2909"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "GA",
            "license": "044-03-241",
            "primary": true
        },
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": "GA",
            "license": "044-03-241",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Court at Decatur",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Decatur, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2009; 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.