Brandywine Senior Living at Mountain Ridge, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

BRANDYWINE SENIOR LIVING AT MOUNTAIN RIDGE, LLC

Practice address

680 Mountain Blvd
Watchung, NJ 07069-6270

Phone

(856) 813-2000

Fax

(856) 813-2020

NPI assigned

Sep 2, 2011

Organization subpart

No

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

Authorized official

Name

Mr. Keith R Phillips

Title

Chief Financial Officer

Phone

(856) 813-2017

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1314921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314921600000",
    "number": "1992086060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 FELLOWSHIP RD",
            "address_2": "SUITE 360",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080543415",
            "telephone_number": "856-813-2000",
            "fax_number": "856-813-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 MOUNTAIN BLVD",
            "city": "WATCHUNG",
            "state": "NJ",
            "postal_code": "070696270",
            "telephone_number": "856-813-2000",
            "fax_number": "856-813-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRANDYWINE SENIOR LIVING AT MOUNTAIN RIDGE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-02",
        "last_updated": "2011-09-02",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "856-813-2017",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Watchung, NJ
• Providers in Watchung, 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 Sep 2, 2011; 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.