Provider Demographics
NPI:1568812147
Name:BRIGHTVIEW TENAFLY, LLC
Entity Type:Organization
Organization Name:BRIGHTVIEW TENAFLY, LLC
Other - Org Name:BRIGHTVIEW TENAFLY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AUTHORIZED SIGNATORY FOR BRIGHTVIEW
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:GREYDANUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-962-0595
Mailing Address - Street 1:55 HUDSON AVENUE
Mailing Address - Street 2:
Mailing Address - City:TENAFLY
Mailing Address - State:NJ
Mailing Address - Zip Code:07670
Mailing Address - Country:US
Mailing Address - Phone:201-510-2060
Mailing Address - Fax:201-569-2975
Practice Address - Street 1:55 HUDSON AVENUE
Practice Address - Street 2:
Practice Address - City:TENAFLY
Practice Address - State:NJ
Practice Address - Zip Code:07670
Practice Address - Country:US
Practice Address - Phone:201-510-2060
Practice Address - Fax:201-569-2975
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-15
Last Update Date:2019-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No311500000XNursing & Custodial Care FacilitiesAlzheimer Center (Dementia Center)