Brookside Manor Llc in Centralia - Nursing Facility/intermediate Care Facility
Brookside Manor Llc - NPI 1457476640
Brookside Manor Llc is a Nursing Facility/intermediate Care Facility in Centralia, Illinois. Brookside Manor Llc practices all healthcare services and medical treatments related to Nursing Facility/intermediate Care Facility. The NPI Number for Brookside Manor Llc is 1457476640. The last update date is 2020-08-22.
Brookside Manor Llc's current location address is 1740 W Mccord St, Centralia, Illinois. You can contact this provider via phone number 6185322428 and fax number 6185328305. The mailing address for Brookside Manor Llc is 1740 W Mccord St, Centralia, Illinois. To know further, please read the information below!
Provider Profile Detail
Provider Organization | Brookside Manor Llc |
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Address | 1740 W Mccord St, Centralia, Illinois |
Phone Number | 6185322428 |
Fax Number | 6185328305 |
Sole Proprietor | -- |
Credentials | -- |
Authorized Official
Title or Position | ADMINISTRA |
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Authorized Official Name | Middleton Lisa |
Telephone Number | 6185322428 |
NPI Number Detail
NPI Number | 1457476640 |
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Provider Enumeration Date | 2007-03-20 |
Last Updated Date | 2020-08-22 |
Provider Mailing Address Detail
Address | 1740 W Mccord St |
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City | Centralia |
State | Illinois (IL) |
Post Code | 628015808 |
Phone Number | 6185322428 |
Fax Number | 6185328305 |
Provider's Primary Taxonomy Detail
Speciality | Nursing Facility/intermediate Care Facility |
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Taxonomy | 313M00000X |
Licence No | 45096 |
Definition: An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the reha |
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What is the unique 10-digit identification code issued to Brookside Manor Llc by the Centers for Medicare & Medicaid Services?
The Brookside Manor Llc has been assigned the NPI (National Provider Identifier) 1457476640 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you please share the complete physical address where Brookside Manor Llc is geographically located?
The Brookside Manor Llc is physically situated at the following location: 1740 W Mccord St, Centralia, IL, 628015808.
What is the Brookside Manor Llc's specialty and taxonomy code?
The Brookside Manor Llc's specialty is Nursing Facility/intermediate Care Facility, and the corresponding taxonomy code is 313M00000X.
On what date did the Brookside Manor Llc receive its 1457476640 assignment from the Centers for Medicare & Medicaid Services?
The Brookside Manor Llc was assigned its 1457476640 by the Centers for Medicare & Medicaid Services on 2007-03-20.
When was the information regarding Brookside Manor Llc, such as address, specialty, and other details, most recently verified or confirmed to be accurate?
The information pertaining to Brookside Manor Llc, including its address, specialty, and other relevant details, was most recently verified or confirmed to be accurate on 2020-08-22.
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