MEDICARE: BROOKDALE SENIOR LIVING COMMUNITIES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1790942985
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BROOKDALE SENIOR LIVING COMMUNITIES, INC.

Provider Business Mailing Address
First Line	:	6737 W WASHINGTON ST
Second Line	:	SUITE 2300
City	:	MILWAUKEE
State	:	WI
Zip	:	53214-5647
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4601 NW 53RD AVE
Second Line	:
City	:	GAINESVILLE
State	:	FL
Zip	:	32606-4382
Country	:	US
Telephone Number	:	352-338-7500
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MARK OHLENDORF
Credential	:
Telephone Number	:	414-918-5000

Provider Enumeration Date	:	05/16/2008
Last Update Date	:	09/24/2015

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