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Organization
BREA CHARLOTTE, LLC
Active
Organization
BREA CHARLOTTE, LLC
Active
Other names
Brookdale South Park
Organization subpart
No
Provider details
NPI number
Authorized official
BRYAN RICHARDSON (EVP, CHIEF ADMIN. OFFICER)
(615) 564-8131
Entity
Organization
Contact information
Practice address
5326 PARK RD, CHARLOTTE, NC 28209-3648
(704) 553-8700
(704) 553-8922
Mailing address
6737 W WASHINGTON ST, SUITE 2300, MILWAUKEE, WI 53214-5647
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
HAL-060-085
NC
311500000X
Alzheimer Center (Dementia Center)
Primary
HAL-060-085
NC
Other
Enumeration date
01/26/2007
Last updated
05/16/2016
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