Organization
EMERITUS PROPERTIES V INC
Active
Other names
Brookdale Orange 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
1248 KINGSLEY AVE, ORANGE PARK, FL 32073-4699
(904) 264-0207
(904) 264-9155
Mailing address
6737 W WASHINGTON ST, SUITE 2300, MILWAUKEE, WI 53214-5647
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL9423
FL
311500000X
Alzheimer Center (Dementia Center)
AL9423
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0097793-00
—
FL
Enumeration date
05/20/2007
Last updated
05/13/2016
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