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Contact Information

BEVERELY PLACE LLC
5763 DE BACA CT NE
RIO RANCHO, NM87144-5213
 Phone: 609-457-4506
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Intermediate Care Facility, Mentally Retarded

315P00000X
Indicates primary specialty

NPI Profile & details for BEVERELY PLACE LLC

NPI Number 1811712987
LBN Legal business name BEVERELY PLACE LLC
Authorized official BAZE BROWNELL - (CEO)
Entity Organization
Organization subpart 1 No
Enumeration date 11/22/2024
Last updated 12/23/2025 - About 6 months ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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