BROOKDALE EDDY POND WEST – NPI #1295936813
Assisted Living Facility

A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

BROOKDALE EDDY POND WEST is an assisted living facility located in AUBURN, MA. NPPES has assigned the NPI number 1295936813 to BROOKDALE EDDY POND WEST on May 30, 2007. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “BROOKDALE EDDY POND WEST” is a dba name, the actual legal business name for this organization is EMERITUS PROPERTIES XIV, LLC. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 310400000X from the Health Care Provider Taxonomy code set, which is classified as Assisted Living Facility.

The NPI profile was previously updated about 10 years ago on Jun 06, 2016. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for BROOKDALE EDDY POND WEST below.

NPI Profile for
EMERITUS PROPERTIES XIV, LLC

NPI Number
1295936813
Enumeration Date

(more than 19 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
EMERITUS PROPERTIES XIV, LLC
Doing Business As (dba): BROOKDALE EDDY POND WEST
Primary location
669 WASHINGTON STREET
AUBURN, MA 01501
Phone: (508) 832-4458 Fax: (508) 832-2861
Mailing address
6737 W WASHINGTON ST, SUITE 2300
MILWAUKEE, WI 53214-5650
Phone: (414) 918-5000 Fax: (508) 832-2861
Organization Subpart
No
Authorized Official
BRYAN RICHARDSON
EVP, CHIEF ADMIN. OFFICER
Phone: (615) 564-8131
Updated
Identifiers

Identifiers for BROOKDALE EDDY POND WEST

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
MEDICAIDMA1905941
MEDICAIDMA1900455
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
310400000X
- Assisted Living Facility (Primary)
MA
302F00000X
- Exclusive Provider Organization
MA EOEA CERTIFICATE ALF

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.