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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