Healthcare Provider Details

I. General information

NPI: 1851535868
Provider Name (Legal Business Name): BROOKDALE SENIOR LIVING COMMUNITIES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2009
Last Update Date: 04/22/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1841 MIDDLE BELLVILLE RD
MANSFIELD OH
44904-1798
US

IV. Provider business mailing address

1841 MIDDLE BELLVILLE RD
MANSFIELD OH
44904-1798
US

V. Phone/Fax

Practice location:
  • Phone: 419-756-5599
  • Fax: 419-756-5578
Mailing address:
  • Phone: 419-756-5599
  • Fax: 419-756-5578

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number2177R
License Number StateOH

VIII. Authorized Official

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