Briarwood Assisted Living

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AH030293792 Issued in MI

Legal business name

BRIARWOOD ASSISTED LIVING

Practice address

620 Ely St
Allegan, MI 49010-1528

Phone

(269) 673-9536

NPI assigned

Nov 17, 2009

Organization subpart

No

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

Authorized official

Name

Toni Kellerman

Title

Administrator

Phone

(269) 673-9536

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Briarwood Assisted Living2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Briarwood Assisted Living, LLC

  • Clinical Medical Laboratory
  • Allegan, MI
  • NPI 1962714782
  NPD tax ID

Locations

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

{
    "created_epoch": "1258416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1425859200000",
    "number": "1861729568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3196 KRAFT AVE SE",
            "address_2": "SUITE 200",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495122078",
            "telephone_number": "616-464-1564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 ELY ST",
            "city": "ALLEGAN",
            "state": "MI",
            "postal_code": "490101528",
            "telephone_number": "269-673-9536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIARWOOD ASSISTED LIVING",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-17",
        "last_updated": "2015-03-09",
        "status": "A",
        "authorized_official_last_name": "KELLERMAN",
        "authorized_official_first_name": "TONI",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "269-673-9536"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MI",
            "license": "AH030293792",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "23D1102194",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kimberly Renee Bouchard, RN, AEMT
• Michelle Boutain, CHW
• Jack Douglas Bower, PTA
• Viktoria K Bradfield, MS/OTR/L
• Colton Jade Braun, LLMSW
• Briarwood Assisted Living, LLC
• Adam Brink, LMSW
• Ronald Orville Brooks
• James Nathan Brown Jr.
• Philip W. Brown, CRNA

• Assisted Living Facility in Allegan, MI
• Providers in Allegan, 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 Mar 9, 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.