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	2214RCF	OH

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	:	1750522389
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BROOKDALE SENIOR LIVING COMMUNITIES INC

Provider Business Mailing Address
First Line	:	1916 S LINCOLN AVE
Second Line	:
City	:	SALEM
State	:	OH
Zip	:	44460-4385
Country	:	US
Telephone Number	:	330-337-9096
Fax Number	:	330-332-9927

Provider Business Practice Location Address
First Line	:	1916 S LINCOLN AVE
Second Line	:
City	:	SALEM
State	:	OH
Zip	:	44460-4385
Country	:	US
Telephone Number	:	330-337-9096
Fax Number	:	330-332-9927

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

Provider Enumeration Date	:	03/11/2009
Last Update Date	:	11/17/2020

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