BREA ROANOKE LLC (NPI# 1831426717) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831426717 |
| Entity Type | Organization |
| Organization Name | BREA ROANOKE LLC |
| Other Organization Name | COURT AT ROANOKE |
| Practice Address |
1127 Persinger Rd Sw Roanoke VA 24015-3829 |
| Mailing Address |
3131 Elliott Ave Suite 500 Seattle WA 98121-1044 |
| Practice Telephone | 5403434900 |
| Practice Fax Number | 5403434900 |
| Mailing Telephone | 2062982909 |
| Mailing Fax Number | 2063014500 |
| Enumeration Date | 2009-11-12 |
| Last Update Date | 2009-11-12 |
| Authorized Official Name | NOELLE DIAZ BICKEL (LICENSING SPECIALIST) |
| Authorized Official Telephone | 2062982909 |
| Is Organization Subpart | Y |
| Parent Organization Name | BREA EMERITUS LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311500000X | Alzheimer Center (Dementia Center) | RO-08-179 | VA | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Court at Roanoke | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | BREA Roanoke LLC | 3131 Elliott Ave Ste 500, Seattle, Washington 98121 |
| Street Address |
1127 PERSINGER RD SW |
| City | ROANOKE |
| State | VA |
| Zip Code | 24015-3829 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184741431 | Rey Adonis Lao | Physical Therapist | 1127 Persinger Rd Sw, Roanoke, VA 24015-3829 | 2007-03-23 |
| 1467994137 | Brandy Gail Brumbaugh | Physical Therapy Assistant | 1127 Persinger Rd Sw, Roanoke, VA 24015-3829 | 2016-11-13 |
| 1013363746 | Timothy Beierle | Physical Therapy Assistant | 1127 Persinger Rd Sw, Roanoke, VA 24015-3829 | 2016-05-12 |
| 1447591128 | Mary E Hale | Occupational Therapist | 1127 Persinger Rd Sw, Roanoke, VA 24015-3829 | 2013-03-06 |
| 1104178417 | Jenna Marie Roberts | Physical Therapy Assistant | 1127 Persinger Rd Sw, Roanoke, VA 24015-3829 | 2012-10-10 |
| 1922306968 | Heather Coleman | Physical Therapy Assistant | 1127 Persinger Rd Sw, Roanoke, VA 24015-3829 | 2011-02-28 |
| 1124324389 | Chelsea Ann Liller | Occupational Therapist | 1127 Persinger Rd Sw, Roanoke, VA 24015-3829 | 2011-02-07 |
| 1942404595 | Crystal Dalton Johnson | Speech-Language Pathologist | 1127 Persinger Rd Sw, Roanoke, VA 24015-3829 | 2007-06-14 |
| 1073632691 | Carole A Sease | Occupational Therapist | 1127 Persinger Rd Sw, Roanoke, VA 24015-3829 | 2007-03-28 |
| 1558480103 | Dorothy Moushegian Gleason | Speech-Language Pathologist | 1127 Persinger Rd Sw, Roanoke, VA 24015-3829 | 2007-03-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326549163 | Manu Singh | Physical Therapist | 1327 Grandin Rd #243, Roanoke, VA 24015 | 2018-02-27 |
| 1952828329 | Lisa Nielsen | Early Intervention Provider Agency | 2112 Maiden Lane Sw, Roanoke, VA 24015 | 2017-08-27 |
| 1518304955 | Blue Ridge Healthcare Partners, LLC | Clinic/Center | 602 Brandon Ave, Suite 222, Roanoke, VA 24015 | 2013-05-24 |
| 1184938185 | Pamela Jean Merritt | Dentist | 2022 Brambleton Ave Sw, Roanoke, VA 24015 | 2010-08-02 |
| 1093957458 | Susan Wohlford | Speech-Language Pathologist | 2030 Colonial Avenue Sw, Roanoke, VA 24015 | 2009-04-01 |
| 1922141811 | Robert Douglas Ross | Dentist | 1602 Grandin Rd, Roanoke, VA 24015 | 2007-02-14 |
| 1043395825 | Michael Burgoon | Chiropractor | 2302 Colonial Ave Sw, Suite A, Roanoke, VA 24015 | 2006-10-27 |
| 1245342237 | Roanoke Family Medicine | Family Medicine | Roanoke Family Medicine Inc, Roanoke, VA 24015 | 2006-08-31 |
| 1861971475 | Molly Amelia Southard | Behavior Technician | 3243 Electric Road Building E Suite 1b, Roanoke, VA 24015 | 2018-08-14 |
| 1740769009 | Makayla Ramsey | Behavior Technician | 3243 Electric Road Building E Suite 1b, Roanoke, VA 24015 | 2018-08-08 |
| Find all providers in zip 24015 | ||||
| Taxonomy Code | 311500000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Alzheimer Center (Dementia Center) |
| 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952940322 | Brightview Fair Oaks, LLC | Alzheimer Center (Dementia Center) | 12725 Lee Highway, Fairfax, VA 22030 | 2020-01-02 |
| 1598217804 | Bh Brightview Baldwin Park Opco, LLC | Alzheimer Center (Dementia Center) | 21 Woodlee Road, Staunton, VA 24401 | 2016-11-03 |
| 1093165672 | Brightview Fairfax, LLC | Alzheimer Center (Dementia Center) | 3450 Gallows Road, Annandale, VA 22003 | 2016-06-15 |
| 1427408020 | Brightview Great Falls, LLC | Alzheimer Center (Dementia Center) | 10200 Colvin Run Road, Great Falls, VA 22066 | 2016-06-15 |
| 1518222074 | Vista Park Memory Care Center, LLC | Alzheimer Center (Dementia Center) | 550 Flank Rd, Petersburg, VA 23805-9114 | 2012-07-11 |
| 1003143983 | Emeritus Corporation | Alzheimer Center (Dementia Center) | 1800 Gaskins Rd, Richmond, VA 23238-4324 | 2009-11-12 |
| 1588812549 | Runk and Pratt of Forest | Alzheimer Center (Dementia Center) | 208 Gristmill Dr, Forest, VA 24551-2604 | 2008-09-03 |
| 1861657439 | Arden Courts of Annandale Va, LLC | Alzheimer Center (Dementia Center) | 7104 Braddock Rd, Annandale, VA 22003-6007 | 2008-07-23 |
| 1861604621 | Vinson Hall Corporation | Alzheimer Center (Dementia Center) | 1728 Kirby Rd, Mclean, VA 22101-4816 | 2007-05-04 |
| 1942506118 | Sunrise Senior Living | Alzheimer Center (Dementia Center) | 3750 Joseph Siewick Dr, Fairfax, VA 22033-1742 | 2011-02-04 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.