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General NPI Number Information
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NPI Number | 1376009894
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Entity Type | Organization
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Legal Business Name | BRIGHTVIEW BETHESDA WOODMONT, LLC
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Dates
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Enumeration Date | 02/20/2019
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Last Update Date | 11/03/2020
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Provider Practice Location Address
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Address Line | 4907 RUGBY AVENUE
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City | BETHESDA
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State | MD
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Zip | 20814
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Country | US
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Telephone | 240-800-7566
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Fax | 240-630-5316
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Provider Business Mailing Address
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Address Line | 4907 RUGBY AVENUE
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City | BETHESDA
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State | MD
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Zip | 20814
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Country | US
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Telephone | 240-800-7566
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Fax | 240-630-5316
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Authorized Official
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Title or Position | PRESIDENT
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Name | DOUG DOLLENBERG JR.
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Credential |
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Telephone | 410-952-0595
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311500000X
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Taxonomy Name | Alzheimer Center (Dementia Center)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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