Bridgewater Avondale Operations, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

BRIDGEWATER AVONDALE OPERATIONS, LLC

Practice address

295 E Van Buren Street
Avondale, AZ 85323

Phone

(602) 603-8200

Fax

(602) 533-7574

NPI assigned

Jan 24, 2019

Organization subpart

No

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

Authorized official

Name

Mrs. Inge G Duran

Title

VP of Finance

Phone

(602) 544-3195

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1548288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548288000000",
    "number": "1932663994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14650 N 78TH WAY, BLDG B",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "85260",
            "telephone_number": "602-544-3195",
            "fax_number": "602-533-7574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "295 E VAN BUREN STREET",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "85323",
            "telephone_number": "602-603-8200",
            "fax_number": "602-533-7574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGEWATER AVONDALE OPERATIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-24",
        "last_updated": "2019-01-24",
        "status": "A",
        "authorized_official_last_name": "DURAN",
        "authorized_official_first_name": "INGE",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "VP OF FINANCE",
        "authorized_official_telephone_number": "602-544-3195",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF HEALTH SERVICES",
            "identifier": "AL10996C",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda Bramlett
• Stephanie Brandt
• Sonja Braswell
• Paul Bratcher, PA-C
• Jamie Breutzmann
• Brighter Opportunities LLC
• Maria Fe Briones, FNP
• Ashley Meagan Brittain
• Wendy Brodel
• Deborah Sue Brooks

• Assisted Living Facility in Avondale, AZ
• Providers in Avondale, AZ by specialty
• Assisted Living Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2019; 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.