NPIMap

Organization Active NPI

Wellbl Portfolio 1 Opco LLC

  • Assisted Living Facility
  • Princeton, NJ
National Provider Identifier
1265023527
Registry record updated Feb 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
WELLBL PORTFOLIO 1 OPCO LLC
Doing business as
Brandywine Living Serenade at Princeton
Practice address
775 Mount Lucas Rd
Princeton, NJ 08540-1954
Phone
(609) 430-4000
Fax
(609) 430-4001
NPI assigned
Jan 29, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2021

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

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Primary

Addresses

Primary practice location

775 Mount Lucas Rd
Princeton, NJ 08540-1954

Mailing address

775 Mount Lucas Rd
Princeton, NJ 08540-1954
Phone (609) 430-4000

Other names 1

  • Brandywine Living Serenade at Princeton Doing business as

National Provider Directory

National Provider Directory
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.

NPI Registry JSON

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": "1265023527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "775 MOUNT LUCAS RD",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085401954",
            "telephone_number": "609-430-4000",
            "fax_number": "609-430-4001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "775 MOUNT LUCAS RD",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085401954",
            "telephone_number": "609-430-4000",
            "fax_number": "609-430-4001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLBL 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 Serenade at Princeton",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Princeton, NJ

Sources for this page

  • 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.