BLC-Brendenwood, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

15A000 Issued in NJ

Legal business name

BLC-BRENDENWOOD, LLC

Practice address

1 Brendenwood Dr
Voorhees, NJ 08043-1656

Phone

(856) 424-7773

NPI assigned

Apr 24, 2012

Organization subpart

Yes

Parent organization

BROOKDALE SENIOR LIVING, INC.As reported in NPPES

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

Authorized official

Name

Joanne Leskowicz

Title

Senior Vice President

Phone

(414) 918-5000

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Brookdale Evesham Doing business as

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

CLIA laboratory certificates

Part of

Brookdale Senior Living Inc

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

{
    "created_epoch": "1335225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646006400000",
    "number": "1568720985",
    "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": "1 BRENDENWOOD DR",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080431656",
            "telephone_number": "856-424-7773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLC-BRENDENWOOD, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BROOKDALE SENIOR LIVING, INC.",
        "enumeration_date": "2012-04-24",
        "last_updated": "2022-02-28",
        "certification_date": "2022-02-28",
        "status": "A",
        "authorized_official_last_name": "LESKOWICZ",
        "authorized_official_first_name": "JOANNE",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT",
        "authorized_official_telephone_number": "414-918-5000"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NJ",
            "license": "15A000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0756431",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brookdale Evesham",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Brookdale Evesham",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Voorhees, NJ
• Assisted Living Facility in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2022; 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.