Basic Information
Provider Information
NPI: 1659336436
EntityType: 2
ReplacementNPI:  
OrganizationName: AUREUS ACQUISITION I, LLC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: BRIGHTON GARDENS OF CARLSBAD
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7900 WESTPARK DR
Address2: ATTN: MEDICARE BILLING, M. GARCIA
City: MC LEAN
State: VA
PostalCode: 221024242
CountryCode: US
TelephoneNumber: 7038540823
FaxNumber: 7038540164
Practice Location
Address1: 3140 EL CAMINO REAL
Address2:  
City: CARLSBAD
State: CA
PostalCode: 920082108
CountryCode: US
TelephoneNumber: 7607209898
FaxNumber: 7607200175
Other Information
ProviderEnumerationDate: 04/18/2006
LastUpdateDate: 06/18/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: HALLECK
AuthorizedOfficialFirstName: NANCY
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: EXECUTIVE DIRECTOR
AuthorizedOfficialTelephone: 7607209898
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
314000000X080000627CACAY Nursing & Custodial Care FacilitiesSkilled Nursing Facility 

No ID Information.


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