Provider Demographics
NPI:1659624278
Name:CHATEAU BRICKYARD MANAGEMENT LLC
Entity Type:Organization
Organization Name:CHATEAU BRICKYARD MANAGEMENT LLC
Other - Org Name:LE CHATEAU AT BRICKYARD PLAZA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO, PRESIDENT & SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-478-4117
Mailing Address - Street 1:1800 SW 1ST AVENUE
Mailing Address - Street 2:# 180
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97201-5362
Mailing Address - Country:US
Mailing Address - Phone:503-684-1123
Mailing Address - Fax:503-684-2533
Practice Address - Street 1:3080 S RICHMOND ST
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84106-3000
Practice Address - Country:US
Practice Address - Phone:801-466-9999
Practice Address - Fax:801-466-7650
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-19
Last Update Date:2012-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility