Provider Demographics
NPI:1922207604
Name:BRIGHTON GARADENS OF WESTLAKE
Entity Type:Organization
Organization Name:BRIGHTON GARADENS OF WESTLAKE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CARMINE
Authorized Official - Middle Name:
Authorized Official - Last Name:CARBONE
Authorized Official - Suffix:
Authorized Official - Credentials:EXECUTIVE DIRECTOR
Authorized Official - Phone:440-808-0074
Mailing Address - Street 1:27819 CENTER RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-3900
Mailing Address - Country:US
Mailing Address - Phone:440-808-0074
Mailing Address - Fax:440-808-0564
Practice Address - Street 1:27819 CENTER RIDGE RD
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-3900
Practice Address - Country:US
Practice Address - Phone:440-808-0074
Practice Address - Fax:440-808-0564
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-13
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility