=====================================================
General NPI Number Information
=====================================================
NPI Number | 1184780710
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BROOKDALE SENIOR LIVING COMMUNITIES, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/28/2006
-----------------------------------------------------
Last Update Date | 12/03/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1200 E KIRWIN AVE
-----------------------------------------------------
City | SALINA
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 67401-6333
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 785-825-8200
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1200 E KIRWIN AVE
-----------------------------------------------------
City | SALINA
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 67401-6333
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 785-825-8200
-----------------------------------------------------
Fax | 785-825-8284
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SENIOR VICE PRESIDENT
-----------------------------------------------------
Name | JOANNE K LESKOWICZ
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 414-918-5000
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 310400000X
-----------------------------------------------------
Taxonomy Name | Assisted Living Facility
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------