Healthcare Provider Details

I. General information

NPI: 1417482647
Provider Name (Legal Business Name): BRIGHTVIEW ROCKVILLE TOWN CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2017
Last Update Date: 01/03/2020
Certification Date: 01/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

285 N. WASHINGTON STREET
ROCKVILLE MD
20850
US

IV. Provider business mailing address

285 N. WASHINGTON STREET
ROCKVILLE MD
20850
US

V. Phone/Fax

Practice location:
  • Phone: 301-284-7214
  • Fax: 240-314-7107
Mailing address:
  • Phone: 301-284-7214
  • Fax: 240-314-7107

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code311500000X
TaxonomyAlzheimer Center (Dementia Center)
License Number
License Number State

VIII. Authorized Official

Name: DAVID GREYDANUS
Title or Position: BRIGHTVIEW ROCKVILLE TOWN CENTER, L
Credential:
Phone: 410-962-0595