1169 Bryden Place LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

1169 BRYDEN PLACE LLC

Practice address

1169 Bryden Rd
Columbus, OH 43205-1979

Phone

(614) 927-2700

NPI assigned

Feb 19, 2021

Last updated

Feb 19, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Julia Ann Mouton Monroe, LPN, CPD, CDAL, PCHA

Title

Executive Director

Phone

(614) 927-2700

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1613692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613692800000",
    "number": "1669065777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1169 BRYDEN RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432051979",
            "telephone_number": "614-927-2700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1169 BRYDEN RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432051979",
            "telephone_number": "614-927-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "1169 BRYDEN PLACE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-19",
        "last_updated": "2021-02-19",
        "certification_date": "2021-02-19",
        "status": "A",
        "authorized_official_last_name": "MONROE",
        "authorized_official_first_name": "JULIA",
        "authorized_official_middle_name": "ANN MOUTON",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "614-927-2700",
        "authorized_official_credential": "LPN, CPD, CDAL, PCHA"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2021; 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.