Brighton Manor LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

BRIGHTON MANOR LLC

Practice address

1320 Rickett Rd
Brighton, MI 48116-1833

Phone

(248) 930-7875

NPI assigned

Jan 14, 2020

Organization subpart

No

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

Authorized official

Name

Mr. Douglas Edward Boehm Jr.

Title

Executive Director

Phone

(248) 930-7875

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1578960000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578960000000",
    "number": "1619517059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 RICKETT RD",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481161833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 RICKETT RD",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481161833",
            "telephone_number": "248-930-7875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIGHTON MANOR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-14",
        "last_updated": "2020-01-14",
        "certification_date": "2020-01-14",
        "status": "A",
        "authorized_official_last_name": "BOEHM",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "248-930-7875",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF MICHIGAN HFA LICENSE",
            "identifier": "AH470387116",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Brighton, MI
• Providers in Brighton, MI by specialty
• Assisted Living Facility in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2020; 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.