Provider Demographics
NPI:1619955523
Name:BRIAR HILL INC
Entity type:Organization
Organization Name:BRIAR HILL INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:REYNOLDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-513-8738
Mailing Address - Street 1:919 OLD WINTER ROAD
Mailing Address - Street 2:
Mailing Address - City:AUBURNDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33823
Mailing Address - Country:US
Mailing Address - Phone:863-967-4125
Mailing Address - Fax:863-551-9407
Practice Address - Street 1:919 OLD WINTER ROAD
Practice Address - Street 2:
Practice Address - City:AUBURNDALE
Practice Address - State:FL
Practice Address - Zip Code:33823
Practice Address - Country:US
Practice Address - Phone:863-967-4125
Practice Address - Fax:863-551-9407
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-03
Last Update Date:2014-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSNF10860951314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL207527Medicaid
105302Medicare Oscar/Certification