Healthcare Provider Details

I. General information

NPI: 1891719548
Provider Name (Legal Business Name): BROOKDALE SENIOR LIVING INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 04/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 N WABASH AVE SUITE 1400
CHICAGO IL
60611-3586
US

IV. Provider business mailing address

330 N WABASH AVE SUITE 1400
CHICAGO IL
60611-3586
US

V. Phone/Fax

Practice location:
  • Phone: 312-977-3700
  • Fax: 312-977-3701
Mailing address:
  • Phone: 312-977-3700
  • Fax: 312-977-3701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. JOHN P RIJOS
Title or Position: PRESIDENT
Credential:
Phone: 312-977-3700