Healthcare Provider Details

I. General information

NPI: 1659437085
Provider Name (Legal Business Name): BROOKDALE SENIOR LIVING COMMUNITIES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2006
Last Update Date: 05/08/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25200 SE STARK ST
GRESHAM OR
97030-8314
US

IV. Provider business mailing address

6737 W WASHINGTON ST SUITE 2300
MILWAUKEE WI
53214-5647
US

V. Phone/Fax

Practice location:
  • Phone: 503-665-4300
  • 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

VIII. Authorized Official

Name: BRYAN RICHARDSON
Title or Position: EXECUTIVE VICE PRESIDENT
Credential:
Phone: 615-221-2250