Healthcare Provider Details

I. General information

NPI: 1730842402
Provider Name (Legal Business Name): BRIGHTSTAR SENIOR LIVING OPERATIONS OF MASON, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2021
Last Update Date: 08/29/2022
Certification Date: 08/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6491 READING RD
MASON OH
45040-3210
US

IV. Provider business mailing address

1125 TRI STATE PKWY STE 700
GURNEE IL
60031-9177
US

V. Phone/Fax

Practice location:
  • Phone: 513-770-9448
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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: LISA KASPER
Title or Position: COMPLIANCE PARALEGAL
Credential:
Phone: 847-693-2003