Provider Demographics
NPI:1598884355
Name:BRIGHAM HOUSE ASSISTED LIVING
Entity Type:Organization
Organization Name:BRIGHAM HOUSE ASSISTED LIVING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARGE
Authorized Official - Middle Name:RUTH
Authorized Official - Last Name:SCHWENDENMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-923-7779
Mailing Address - Street 1:BRIGHAM HOUSE
Mailing Address - Street 2:341 MOUNT AUBURN ST
Mailing Address - City:WATERTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02472
Mailing Address - Country:US
Mailing Address - Phone:617-923-6239
Mailing Address - Fax:
Practice Address - Street 1:BRIGHAM HOUSE
Practice Address - Street 2:341 MOUNT AUBURN ST
Practice Address - City:WATERTOWN
Practice Address - State:MA
Practice Address - Zip Code:02472
Practice Address - Country:US
Practice Address - Phone:617-923-6239
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1905449Medicaid