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Organization
EMERITUS PROPERTIES XIV, LLC
Active
Organization
EMERITUS PROPERTIES XIV, LLC
Active
Other names
Brookdale Eddy Pond West
Organization subpart
No
Provider details
NPI number
Authorized official
BRYAN RICHARDSON (EVP, CHIEF ADMIN. OFFICER)
(615) 564-8131
Entity
Organization
Contact information
Practice address
669 WASHINGTON STREET, AUBURN, MA 01501
(508) 832-4458
(508) 832-2861
Mailing address
6737 W WASHINGTON ST, SUITE 2300, MILWAUKEE, WI 53214-5650
(414) 918-5000
(508) 832-2861
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
EOEA CERTIFICATE ALF
MA
310400000X
Assisted Living Facility
Primary
—
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1900455
—
MA
05
—
1905941
—
MA
Enumeration date
05/30/2007
Last updated
06/06/2016
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