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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1205992492
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BROOKDALE SENIOR LIVING COMMUNITIES, INC.

Provider Business Mailing Address
First Line	:	111 WESTWOOD PL STE 400
Second Line	:
City	:	BRENTWOOD
State	:	TN
Zip	:	37027-5057
Country	:	US
Telephone Number	:	615-221-2250
Fax Number	:

Provider Business Practice Location Address
First Line	:	3902 W ADAMS AVE
Second Line	:
City	:	TEMPLE
State	:	TX
Zip	:	76504-3500
Country	:	US
Telephone Number	:	254-791-8000
Fax Number	:	254-791-8003

Authorized Official
Title or Position	:	SENIOR VICE PRESIDENT
Name	:	JOANNE K LESKOWICZ
Credential	:
Telephone Number	:	414-918-5000

Provider Enumeration Date	:	12/29/2006
Last Update Date	:	09/01/2020

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