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BROOKDALE LAKE MARY
NPI 1184834228
Assisted Living Facility in Lake Mary, FL

Active since May 23, 2007CLIA 10D0994506 · Waiver
150 MIDDLE STREET, LAKE MARY, FL 32746(407) 321-7550(407) 321-7550 Get Directions Write a Review

NPPES record last updated: June 13, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Brookdale Lake Mary NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BROOKDALE LAKE MARY (NPI 1184834228) is a healthcare organization registered as an assisted living facility in Lake Mary, Florida and active in the NPI registry since May 2007. The organization holds a CLIA Waiver certificate valid through December 23, 2027 and lists Bryan Richardson, Evp, Chief Admin. Officer, as its authorized official.

NPPES Registry Identity

NPI1184834228
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameSUMMERVILLE 3, LLC
Location Address150 MIDDLE STREETLake Mary, FL 32746
Mailing Address6737 W Washington St Ste 2300Milwaukee, WI 53214-5650 · (414) 918-5000 · Fax (206) 301-4500
Phone(407) 321-7550
Fax(407) 321-7550
Organization SubpartNo
Authorized OfficialBryan RichardsonEvp, Chief Admin. Officer · (615) 564-8131
Enumeration DateMay 23, 2007
Last NPPES UpdateJune 13, 2016
✔ NPI 1184834228 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
License✔ Licensed in FL · AL10162
Definition
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.
Also ListedAlzheimer Center (Dementia Center)Taxonomy 311500000X · License AL10162 (FL)
150 MIDDLE STREET, Lake Mary, FL 32746
Open in Google Maps ↗

Other Names 1

Doing Business AsBrookdale Lake Mary

Other Identifiers 1

Medicaid0089537-00FL

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D0994506

Brookdale Lake Mary · Lake Mary, FL
Active · expires Dec 23, 2027
CLIA Number10D0994506
Laboratory TypeOther
Certificate Effective DateDecember 24, 2025
Certificate Expiration DateDecember 23, 2027
Laboratory DirectorTammy Cain
Laboratory Phone(407) 321-7550
Laboratory LocationBrookdale Lake Mary150 Middle St, Lake Mary, FL 32746
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ROWENA J MONTAGUE PT
Physical Therapist
150 MIDDLE STREET
LAKE MARY, FL 32746
Seminole County (407) 585-1210

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Summerville 3, LLC's NPI number?

The NPI number for Summerville 3, LLC is 1184834228. It was assigned to this organization in the NPPES registry on May 23, 2007. The provider is doing business as Brookdale Lake Mary.

Where is Summerville 3, LLC located?

Summerville 3, LLC is located at 150 Middle Street, Lake Mary, FL 32746. The listed phone number is (407) 321-7550.

What is Summerville 3, LLC's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Does Summerville 3, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D0994506) is associated with this NPI, valid through December 23, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Summerville 3, LLC was last updated on June 13, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.