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Organization

BREA EAST MESA, LLC

Active
Other names
Brookdale Palmer 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
2850 N ACADEMY BLVD, COLORADO SPRINGS, CO 80917
(480) 832-1300
(480) 638-0841
Mailing address
6737 W WASHINGTON ST STE 2300, MILWAUKEE, WI 53214-5650
(414) 918-5000
(206) 301-4500

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
2305S9
CO
310400000X
Assisted Living Facility
Primary
68533250
CO
311500000X
Alzheimer Center (Dementia Center)
2305S9
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00000
PRIVATE
05
205629
CO
05
79559301
CO
Enumeration date
02/05/2008
Last updated
06/13/2016
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