Organization Active NPI

Mira Vie at Brick Opco LLC

Doing business as Mira Vie at Brick

  • Assisted Living Facility
  • Brick, NJ
National Provider Identifier
1306694203
Registry record updated May 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
MIRA VIE AT BRICK OPCO LLC
Doing business as
Mira Vie at Brick
Practice address
458 Jack Martin Blvd
Brick, NJ 08724-7739
Phone
(732) 236-7981
Fax
(844) 808-0071
NPI assigned
May 7, 2024
Last updated
May 7, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 7, 2024

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

Authorized official

Name
Billie Abreu
Title
Director of Admin
Phone
(813) 330-2660

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Primary

Addresses

Primary practice location

458 Jack Martin Blvd
Brick, NJ 08724-7739

Mailing address

4301 Anchor Plaza Pkwy Ste 300
Tampa, FL 33634-7521
Phone (813) 330-2660

Other names 1

  • Mira Vie at Brick Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
31D2194608Mira Vie at Brick458 Jack Martin Blvd, Brick, NJ 08724Certificate of waiverSep 30, 2026

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1715040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715040000000",
    "number": "1306694203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 ANCHOR PLAZA PKWY STE 300",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336347521",
            "telephone_number": "813-330-2660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "458 JACK MARTIN BLVD",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087247739",
            "telephone_number": "732-236-7981",
            "fax_number": "844-808-0071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIRA VIE AT BRICK OPCO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-07",
        "last_updated": "2024-05-07",
        "certification_date": "2024-05-07",
        "status": "A",
        "authorized_official_last_name": "ABREU",
        "authorized_official_first_name": "BILLIE",
        "authorized_official_title_or_position": "DIRECTOR OF ADMIN",
        "authorized_official_telephone_number": "813-330-2660"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mira Vie at Brick",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brick, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2024; 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.