Brandywine Senior Living at Mahwah

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

02A024 Issued in NJ

Legal business name

BRANDYWINE SENIOR LIVING AT MAHWAH

Practice address

814 Wyckoff Ave
Mahwah, NJ 07430-3132

Phone

(201) 800-8070

Fax

(201) 800-8041

NPI assigned

Aug 14, 2015

Organization subpart

No

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

Authorized official

Name

Mr. Keith Phillips

Title

Chief Financial Officer

Phone

(856) 813-2000

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1439510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439510400000",
    "number": "1811363757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "814 WYCKOFF AVE",
            "city": "MAHWAH",
            "state": "NJ",
            "postal_code": "074303132",
            "telephone_number": "201-800-8070",
            "fax_number": "201-800-8041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "814 WYCKOFF AVE",
            "city": "MAHWAH",
            "state": "NJ",
            "postal_code": "074303132",
            "telephone_number": "201-800-8070",
            "fax_number": "201-800-8041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRANDYWINE SENIOR LIVING AT MAHWAH",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-14",
        "last_updated": "2015-08-14",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "KEITH",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "856-813-2000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NJ",
            "license": "02A024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Judith Biderman
• Janel Whelahan Blake, LSW
• Debra Borden, LCSW
• Margaret Lillian Bost, L.C.S.W.
• Siovanna Rosas Boyle, PT
• Ryan Breznovits, PT, DPT
• Katarzyna Franciszka Brzenia, RN
• Laura K Byrnes, LPC
• Caids Therapy Services
• Camp Acorn, Inc.

• Assisted Living Facility in Mahwah, NJ
• Providers in Mahwah, NJ by specialty
• Assisted Living Facility in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2015; 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.