Beverely Place LLC

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

Legal business name

BEVERELY PLACE LLC

Practice address

5763 De Baca CT NE
Rio Rancho, NM 87144-5213

Phone

(609) 457-4506

NPI assigned

Nov 22, 2024

Organization subpart

No

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

Authorized official

Name

Baze Brownell, RN

Title

Ceo

Phone

(877) 963-2123

Specialties & licenses 1

Addresses

Other names 2

• BEVERELY PLACE Doing business as
• BEVERELY PLACE LLC Former legal business name

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

{
    "created_epoch": "1732233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1766448000000",
    "number": "1811712987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5763 DE BACA CT NE",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871445213",
            "telephone_number": "505-395-8682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5763 DE BACA CT NE",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871445213",
            "telephone_number": "609-457-4506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEVERELY PLACE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-22",
        "last_updated": "2025-12-23",
        "certification_date": "2025-12-23",
        "status": "A",
        "authorized_official_last_name": "BROWNELL",
        "authorized_official_first_name": "BAZE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "877-963-2123",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BEVERELY PLACE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "BEVERELY PLACE LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Intellectual Disabilities Intermediate Care Facility in Rio Rancho, NM
• Providers in Rio Rancho, NM by specialty
• Intellectual Disabilities Intermediate Care Facility in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2025; 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.