Provider Demographics
NPI:1144422676
Name:SOLOMON HOLDINGS I - THE TRIANGLE, LLC
Entity Type:Organization
Organization Name:SOLOMON HOLDINGS I - THE TRIANGLE, LLC
Other - Org Name:BRIGHTON GARDENS OF WHEATON
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:FREY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-681-1234
Mailing Address - Street 1:831 BUTTERFIELD RD
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60187-8674
Mailing Address - Country:US
Mailing Address - Phone:630-681-1234
Mailing Address - Fax:
Practice Address - Street 1:831 BUTTERFIELD RD
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60187-8674
Practice Address - Country:US
Practice Address - Phone:630-681-1234
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL5101636310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility