Provider Demographics
NPI:1366483711
Name:SOLOMON HOLDINGS I - THE TRIANGLE LLC
Entity Type:Organization
Organization Name:SOLOMON HOLDINGS I - THE TRIANGLE LLC
Other - Org Name:BRIGHTON GARDENS OF PRAIRIE VILLAGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHWINGEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-262-1611
Mailing Address - Street 1:7900 WESTPARK DR
Mailing Address - Street 2:T-900, ATTN: MEDICARE BILLING, M. GARCIA
Mailing Address - City:MC LEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22102-4242
Mailing Address - Country:US
Mailing Address - Phone:703-854-0823
Mailing Address - Fax:703-854-0158
Practice Address - Street 1:7105 MISSION RD
Practice Address - Street 2:
Practice Address - City:PRAIRIE VILLAGE
Practice Address - State:KS
Practice Address - Zip Code:66208-3077
Practice Address - Country:US
Practice Address - Phone:913-262-1611
Practice Address - Fax:913-262-0204
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-09
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSN046049314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS175499Medicare Oscar/Certification