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BREA CHARLOTTE LLC NPI 1306992664


NPI Information

NPI: 1306992664
Provider Name: BREA CHARLOTTE, LLC

Doing Business As: BROOKDALE SOUTH PARK

Classification: Alzheimer Center (Dementia Center) - 311500000X
Entity Type: Organization

CLIA Number: 34D2057998

Address:
5326 PARK RD
CHARLOTTE, NC
ZIP 28209
Phone: (704) 553-8700
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BREA CHARLOTTE, LLC is an alzheimer center dementia center in Charlotte, NC. The provider is a freestanding facility or special care unit of a long term care facility focusing on patient care of individuals diagnosed with dementia or Alzheimer's Disease or their related diseases. Six elements of the facility/unit set it apart from other (the rest of the) facilities(y): Admission of residents with dementia (including those with Alzheimer's disease); Staff who are specially selected, trained, and supervised; Activities that are specifically designed for the cognitively impaired; A marketing of a special care unit in brochures; A high level of family involvement; and A physical environment designed to keep residents safe and segregated from other populations. BREA CHARLOTTE, LLC NPI is 1306992664. The provider is registered as an organization entity type.
The provider Is Doing Business As Brookdale South Park.

The provider's business location address is:

5326 PARK RD
CHARLOTTE, NC
ZIP 28209-648
Phone: (704) 553-8700
Fax: (704) 553-8922

The provider's authorized official is Bryan Richardson .
The authorized official title is Evp, Chief Admin. Officer and has the following contact phone number (615) 564-8131.

The CLIA number assigned to this NPI record is 34D2057998 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/26/2007 and was last updated on 5/16/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1310400000XAssisted Living FacilityHAL-060-085NORTH CAROLINANo
2311500000XAlzheimer Center (Dementia Center)HAL-060-085NORTH CAROLINAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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