BROOKDALE ORANGE PARK
NPI 1508074733
Assisted Living Facility in Orange Park, FL

Q: What is Emeritus Properties V Inc's NPI number?

The NPI number for Emeritus Properties V Inc is 1508074733. It was assigned to this organization in the NPPES registry on May 20, 2007. The provider is doing business as Brookdale Orange Park.

Q: What is Emeritus Properties V Inc's specialty?

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

Active since May 20, 2007CLIA 10D1017281 · Waiver

1248 KINGSLEY AVE, ORANGE PARK, FL 32073(904) 264-0207(904) 264-9155 Get Directions Write a Review

NPPES record last updated: May 13, 2016. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Brookdale Orange Park NPPES

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

BROOKDALE ORANGE PARK (NPI 1508074733) is a healthcare organization registered as an assisted living facility in Orange Park, Florida and active in the NPI registry since May 2007. The organization holds a CLIA Waiver certificate valid through October 11, 2027 and lists Bryan Richardson, Evp, Chief Admin. Officer, as its authorized official.

NPPES Registry Identity

NPI1508074733

Entity TypeOrganization

Primary Taxonomy310400000X

Legal Business NameEMERITUS PROPERTIES V INC

Location Address1248 KINGSLEY AVEOrange Park, FL 32073-4699

Mailing Address6737 W Washington St, Suite 2300Milwaukee, WI 53214-5647

Phone(904) 264-0207

Fax(904) 264-9155

Organization SubpartNo

Authorized OfficialBryan RichardsonEvp, Chief Admin. Officer · (615) 564-8131

Enumeration DateMay 20, 2007

Last NPPES UpdateMay 13, 2016

✔ NPI 1508074733 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 · AL9423

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 AL9423 (FL)

1248 KINGSLEY AVE, Orange Park, FL 32073

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Other Names 1

Doing Business AsBrookdale Orange Park

Other Identifiers 1

Medicaid0097793-00FL

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 10D1017281

Brookdale Orange Park · Orange Park, FL

Active · expires Oct 11, 2027

CLIA Number10D1017281

Laboratory TypeAssisted Living Facility

Certificate Effective DateOctober 12, 2025

Certificate Expiration DateOctober 11, 2027

Laboratory DirectorIris Brown

Laboratory Phone(904) 264-0207

Laboratory LocationBrookdale Orange Park1248 Kinglsey Ave, Orange Park, FL 32073

CLIA data matches this NPI record on: Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 11

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

AMANDA LEIGH GILBERT COTA/L

Occupational Therapy Assistant