Countryside Nursing And Rehabilitation Community
LBN: Atrium Countryside Llc
Countryside Nursing And Rehabilitation Community is an health care organization with primary practice located at 120 Baseline Rd , South Haven MI 49090-1037. The organization recently has 2 registered licenses in different health care specialties including Nursing & Custodial Care Facilities / Assisted Living Facility, Nursing & Custodial Care Facilities / Skilled Nursing Facility. Nursing & Custodial Care Facilities / Assisted Living Facility is the primary health care specialty.
Atrium Countryside Llc can be contacted via phone (269) 637-8411, or through Lockhart, Dennis via phone (614) 416-0600.
Contact Information
Primary practice address
120 Baseline Rd
South Haven MI 49090-1037
Phone: (269) 637-8411
Fax: (269) 637-8460
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Nursing & Custodial Care Facilities / Assisted Living Facility | 310400000X | AH800236748 | Michigan |
| Nursing & Custodial Care Facilities / Skilled Nursing Facility | 314000000X | 80-4050 | Michigan |
Profile Details
| NPI number | 1497753834 |
|---|---|
| LBN Legal business name | Atrium Countryside Llc |
| DBA Doing business as | Countryside Nursing And Rehabilitation Community |
| Authorized official | Lockhart, Dennis |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jul 11th, 2005 |
| Last updated | Feb 13th, 2014 - about 12 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1497753834 | NPPES |
| Michigan | Other | S 9517 | BCBS PROVIDER CODE |
| Michigan | MEDICAID | 60 4191457 | BCBS PROVIDER CODE |
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