NPIMap

Organization Active NPI

Brea Wayne, LLC

Doing business as Brookdale Wayne

  • Assisted Living Facility
  • Wayne, NJ
National Provider Identifier
1891903175
Registry record updated May 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
70A003 Issued in NJ
Legal business name
BREA WAYNE, LLC
Doing business as
Brookdale Wayne
Practice address
820 Hamburg Tpke
Wayne, NJ 07470-2019
Phone
(973) 942-4800
NPI assigned
May 18, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2016

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

Authorized official

Name
Bryan Richardson
Title
Evp, Chief Admin. Officer
Phone
(615) 564-8131

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 70A003 NJ Primary

Addresses

Primary practice location

820 Hamburg Tpke
Wayne, NJ 07470-2019

Mailing address

6737 W Washington St
Suite 2300
Milwaukee, WI 53214-5647

Other identifiers 1

IdentifierTypeStateIssuer
0129291MedicaidNJ

Other names 1

  • Brookdale Wayne Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
31D2193458Brookdale Wayne820 Hamburg Turnpike, Wayne, NJ 07470Certificate of waiverSep 21, 2026

National Provider Directory

National Provider Directory
Tax ID family
Brea Charlotte LLC25 organizations share this tax ID, including this one

Other organizations with this tax ID 24

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

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463356800000",
    "number": "1891903175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6737 W WASHINGTON ST",
            "address_2": "SUITE 2300",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532145647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 HAMBURG TPKE",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074702019",
            "telephone_number": "973-942-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BREA WAYNE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-18",
        "last_updated": "2016-05-16",
        "status": "A",
        "authorized_official_last_name": "RICHARDSON",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_title_or_position": "EVP, CHIEF ADMIN. OFFICER",
        "authorized_official_telephone_number": "615-564-8131"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NJ",
            "license": "70A003",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0129291",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brookdale Wayne",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wayne, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.