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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