Provider Demographics
NPI:1447264528
Name:BRILEY FACILITY OPERATIONS, LLC
Entity type:Organization
Organization Name:BRILEY FACILITY OPERATIONS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:CONTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-571-1550
Mailing Address - Street 1:800 CONCOURSE PKWY S
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-6148
Mailing Address - Country:US
Mailing Address - Phone:407-571-1550
Mailing Address - Fax:407-571-1599
Practice Address - Street 1:3425 KNIGHT DR
Practice Address - Street 2:
Practice Address - City:WHITES CREEK
Practice Address - State:TN
Practice Address - Zip Code:37189-9189
Practice Address - Country:US
Practice Address - Phone:615-876-2754
Practice Address - Fax:615-876-9499
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CONSULATE HEALTH CARE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-27
Last Update Date:2007-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0445281Medicaid
TN7440544Medicaid
44-5281Medicare PIN
TN0445281Medicaid