Provider Demographics
NPI:1598232191
Name:HCP BETHESDA MD OPCO, LLC
Entity Type:Organization
Organization Name:HCP BETHESDA MD OPCO, LLC
Other - Org Name:BRIGHTON GARDENS OF TUCKERMAN LANE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ADAEZE
Authorized Official - Middle Name:
Authorized Official - Last Name:IKEOTUONYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-897-8566
Mailing Address - Street 1:5550 TUCKERMAN LN
Mailing Address - Street 2:
Mailing Address - City:NORTH BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20852-4683
Mailing Address - Country:US
Mailing Address - Phone:301-897-8566
Mailing Address - Fax:301-897-8845
Practice Address - Street 1:5550 TUCKERMAN LN
Practice Address - Street 2:
Practice Address - City:NORTH BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20852-4683
Practice Address - Country:US
Practice Address - Phone:301-897-8566
Practice Address - Fax:301-897-8845
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-01
Last Update Date:2021-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility