NPIMap

Organization Active NPI

Brea West Orange, LLC

Doing business as Brookdale West Orange

  • Assisted Living Facility
  • West Orange, NJ
National Provider Identifier
1518001817
Registry record updated Jun 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
30A001 Issued in NJ
Legal business name
BREA WEST ORANGE, LLC
Doing business as
Brookdale West Orange
Practice address
520 Prospect Ave
West Orange, NJ 07052-3229
Phone
(973) 325-5700
Fax
(973) 325-6800
NPI assigned
Feb 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 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 30A001 NJ Primary

Addresses

Primary practice location

520 Prospect Ave
West Orange, NJ 07052-3229

Mailing address

6737 W Washington St Ste 2300
Milwaukee, WI 53214-5650
Phone (414) 918-5000

Other identifiers 1

IdentifierTypeStateIssuer
0129321MedicaidNJ

Other names 1

  • Brookdale West Orange 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
31D2195955Brookdale West Orange520 Prospect Avenue, West Orange, NJ 07052Certificate of waiverOct 13, 2026

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": "1171843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465776000000",
    "number": "1518001817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6737 W WASHINGTON ST STE 2300",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532145650",
            "telephone_number": "414-918-5000",
            "fax_number": "206-301-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 PROSPECT AVE",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070523229",
            "telephone_number": "973-325-5700",
            "fax_number": "973-325-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BREA WEST ORANGE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-19",
        "last_updated": "2016-06-13",
        "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": "NJ",
            "license": "30A001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0129321",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brookdale West Orange",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in West Orange, NJ

Sources for this page

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