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BRENTWOOD AT NILES
NPI 1639405608
Assisted Living Facility in Niles, MI

Active since October 27, 2009CLIA 23D2205906 · Waiver
1147 S 3RD ST, NILES, MI 49120(269) 684-9470(269) 684-9477 Get Directions Write a Review

NPPES record last updated: October 27, 2009. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Brentwood At Niles NPPES

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

BRENTWOOD AT NILES (NPI 1639405608) is a healthcare organization registered as an assisted living facility in Niles, Michigan and active in the NPI registry since October 2009. The organization holds a CLIA Waiver certificate valid through December 15, 2026 and lists Noelle Diaz Bickel, Licensing Specialist, as its authorized official.

NPPES Registry Identity

NPI1639405608
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameSUMMERVILLE 2, LLC
Location Address1147 S 3RD STNiles, MI 49120-3459
Mailing Address3131 Elliott Ave, Suite 500Seattle, WA 98121-1044 · (206) 298-2909 · Fax (206) 301-4500
Phone(269) 684-9470
Fax(269) 684-9477
Organization SubpartYesParent: Summerville Investors, Llc
Authorized OfficialNoelle Diaz BickelLicensing Specialist · (206) 298-2909
Enumeration DateOctober 27, 2009
✔ NPI 1639405608 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
License✔ Licensed in MI · AH110271200
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.
1147 S 3RD ST, Niles, MI 49120
Open in Google Maps ↗

Other Names 1

Doing Business AsBrentwood At Niles

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 23D2205906

Brentwood At Niles · Niles, MI
Active · expires Dec 15, 2026
CLIA Number23D2205906
Laboratory TypeAssisted Living Facility
Certificate Effective DateDecember 16, 2024
Certificate Expiration DateDecember 15, 2026
Laboratory DirectorStephanie Lisenko
Laboratory Phone(269) 684-9470
Laboratory LocationBrentwood At Niles1147 S 3rd St, Niles, MI 49120
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 11

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

SHARON R WILKINSON OTR
Occupational Therapist
1147 S 3RD ST
NILES, MI 49120
Berrien County (269) 684-9470
MELANIE SHEPHARD MA, SLP
Speech-Language Pathologist
1147 S 3RD ST
NILES, MI 49120
Berrien County (269) 684-9470
ASHLEY L DZIUBINSKI MOTR
Occupational Therapist
1147 S 3RD ST
NILES, MI 49120
Berrien County (269) 684-9470
LYNDA SALLEE
Nursing Home Administrator
1147 S 3RD ST
NILES, MI 49120
Berrien County (269) 684-9470
GHAC3 NILES MI ALF TRS SUB LLC
Nursing Care
1147 S 3RD ST
NILES, MI 49120
Berrien County (269) 684-9470
TAMARA T ALBY PT
Physical Therapist
1147 S 3RD ST
NILES, MI 49120
Berrien County (269) 684-9470
JOSEPH HOUSTON CAPPS RPT
Physical Therapist
1147 S 3RD ST
NILES, MI 49120
Berrien County (269) 684-9470
GAHC3 NILES MI ALF TRS SUB, LLC
Assisted Living Facility
1147 S 3RD ST
NILES, MI 49120
Berrien County (269) 910-7467

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 2, LLC's NPI number?

The NPI number for Summerville 2, LLC is 1639405608. It was assigned to this organization in the NPPES registry on October 27, 2009. The provider is doing business as Brentwood At Niles.

Where is Summerville 2, LLC located?

Summerville 2, LLC is located at 1147 S 3rd St, Niles, MI 49120. The listed phone number is (269) 684-9470.

What is Summerville 2, LLC's specialty?

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

Does Summerville 2, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 23D2205906) is associated with this NPI, valid through December 15, 2026. 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 2, LLC was last updated on October 27, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.