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General NPI Number Information
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NPI Number | 1568101830
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Entity Type | Organization
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Legal Business Name | BH BRIGHTVIEW HOLDINGS INNOVATION CENTER TRS OPCO, LLC
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Dates
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Enumeration Date | 06/03/2022
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Last Update Date | 12/08/2022
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Provider Practice Location Address
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Address Line | 13700 MAGNA WAY
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City | HERNDON
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State | VA
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Zip | 20171
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Country | US
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Telephone | 571-786-5800
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Fax | 571-786-5814
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Provider Business Mailing Address
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Address Line | 13700 MAGNA WAY
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City | HERNDON
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State | VA
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Zip | 20171
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Country | US
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Telephone | 571-786-5800
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Fax | 571-786-5814
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Authorized Official
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Title or Position | AUTHORIZED SIGNATORY
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Name | BRIAN ENGLE
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Credential |
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Telephone | 410-962-0595
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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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