Active NPI
Mira Vie at Brick Opco LLC
Doing business as Mira Vie at Brick
- Assisted Living Facility
- Brick, NJ
National Provider Identifier
1306694203
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Assisted Living Facility
- 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, 2024
- Organization subpart
- No
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 31D2194608 | Mira Vie at Brick | Certificate of waiver | Sep 30, 2026 |
National Provider Directory
National Provider DirectoryNPI 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
- Kristin Mills, LSW
- Edward Michael Millward, DMD
- Kristopher Mincieli, DO
- Mindful Therapy Solutions, LLC (Mindful Healing and Trauma Recovery)
- Mackenzie Rose Minogue, PHARMD
- Robin Mirabelli
- Natalie Mischenko, MA, LCADC
- Mariam Missak
- MLH Psychological Services, LLC (Balance Mental Wellness, LLC)
- Modern RX Limited Liability Company (Modern Medicine Rx)
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.