Provider Demographics
NPI:1730974957
Name:BRICKWOOD ASSISTED LIVING LLC
Entity type:Organization
Organization Name:BRICKWOOD ASSISTED LIVING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANGER
Authorized Official - Prefix:
Authorized Official - First Name:ADEBOLA
Authorized Official - Middle Name:
Authorized Official - Last Name:OJO
Authorized Official - Suffix:
Authorized Official - Credentials:MPH
Authorized Official - Phone:443-806-5766
Mailing Address - Street 1:5307 ELBURN LN
Mailing Address - Street 2:
Mailing Address - City:ROCK HALL
Mailing Address - State:MD
Mailing Address - Zip Code:21661-2224
Mailing Address - Country:US
Mailing Address - Phone:443-806-5766
Mailing Address - Fax:410-639-7236
Practice Address - Street 1:5307 ELBURN LN
Practice Address - Street 2:
Practice Address - City:ROCK HALL
Practice Address - State:MD
Practice Address - Zip Code:21661-2224
Practice Address - Country:US
Practice Address - Phone:443-806-5766
Practice Address - Fax:410-639-7236
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-09
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
No347C00000XTransportation ServicesPrivate Vehicle
No253Z00000XAgenciesIn Home Supportive Care
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)