National Provider Identifier Database

BEVERELY PLACE LLC
Intermediate Care Facility, Mentally Retarded

(1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals.


Contact Information

BEVERELY PLACE LLC
5763 DE BACA CT NE
RIO RANCHO, NM87144-5213
Phone: 609-457-4506
Fax:
Website:
Specialty Taxonomy Code
* Intermediate Care Facility, Mentally Retarded 315P00000X

* Indicates primary specialty

NPI Profile & details for BEVERELY PLACE LLC

NPI Number 1811712987
Legal business name
LBN
BEVERELY PLACE LLC
Authorized official BAZE BROWNELL - (CEO)
Entity Organization
Organization subpart No
Enumeration date 11/22/2024
Last updated 12/23/2025 - About 6 months ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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