Provider Demographics
NPI:1376009894
Name:BRIGHTVIEW BETHESDA WOODMONT, LLC
Entity Type:Organization
Organization Name:BRIGHTVIEW BETHESDA WOODMONT, LLC
Other - Org Name:BRIGHTVIEW BETHESDA WOODMONT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DOUG
Authorized Official - Middle Name:
Authorized Official - Last Name:DOLLENBERG
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:410-952-0595
Mailing Address - Street 1:4907 RUGBY AVENUE
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814
Mailing Address - Country:US
Mailing Address - Phone:240-800-7566
Mailing Address - Fax:240-630-5316
Practice Address - Street 1:4907 RUGBY AVENUE
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814
Practice Address - Country:US
Practice Address - Phone:240-800-7566
Practice Address - Fax:240-630-5316
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-20
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No311500000XNursing & Custodial Care FacilitiesAlzheimer Center (Dementia Center)