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Organization
BEVERELY PLACE LLC
Active
Organization
BEVERELY PLACE LLC
Active
Other names
BEVERELY PLACE, BEVERELY PLACE LLC
Organization subpart
No
Provider details
NPI number
Authorized official
BAZE BROWNELL RN (CEO)
(877) 963-2123
Entity
Organization
Contact information
Practice address
5763 DE BACA CT NE, RIO RANCHO, NM 87144-5213
(609) 457-4506
Mailing address
5763 DE BACA CT NE, RIO RANCHO, NM 87144-5213
(505) 395-8682
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Enumeration date
11/22/2024
Last updated
12/23/2025
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