NPIMap

Organization Active NPI

Brea Boynton Village, LLC

  • Assisted Living Facility
  • Boynton Beach, FL
National Provider Identifier
1346442837
Registry record updated May 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
AL8189 Issued in FL
Legal business name
BREA BOYNTON VILLAGE, LLC
Practice address
1935 S Federal Hwy
Boynton Beach, FL 33435-6967
Phone
(561) 736-2424
Fax
(561) 738-1205
NPI assigned
Jun 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2016

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

Authorized official

Name
Bryan Richardson
Title
Evp, Chief Admin. Officer
Phone
(615) 564-8131

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X AL8189 FL Primary

Addresses

Primary practice location

1935 S Federal Hwy
Boynton Beach, FL 33435-6967

Mailing address

6737 W Washington St
Suite 2300
Milwaukee, WI 53214-5647

Other identifiers 1

IdentifierTypeStateIssuer
0103581-00MedicaidFL

Other names 1

  • Brookdale East Boynton Beach Doing business as

National Provider Directory

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

Other organizations with this tax ID 24

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

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1181001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463097600000",
    "number": "1346442837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6737 W WASHINGTON ST",
            "address_2": "SUITE 2300",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532145647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1935 S FEDERAL HWY",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334356967",
            "telephone_number": "561-736-2424",
            "fax_number": "561-738-1205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BREA BOYNTON VILLAGE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-05",
        "last_updated": "2016-05-13",
        "status": "A",
        "authorized_official_last_name": "RICHARDSON",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_title_or_position": "EVP, CHIEF ADMIN. OFFICER",
        "authorized_official_telephone_number": "615-564-8131"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL8189",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0103581-00",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brookdale East Boynton Beach",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Boynton Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2016; 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.