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:
Map and Directions
Authorized official contact:
Name: Lockhart, Dennis
Phone: (614) 416-0600

Health care specialties

SpecialtyCodeLicense #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 10 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1497753834 NPPES
Michigan Other S 9517 BCBS PROVIDER CODE
Michigan MEDICAID 60 4191457 BCBS PROVIDER CODE

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