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Brookside Manor Llc
Nursing Facility/Intermediate Care Facility in Centralia, Illinois
NPI 1457476640

Brookside Manor Llc is a Nursing Facility/Intermediate Care Facility based in Centralia, IL. Brookside Manor Llc practices in Centralia, IL. The NPI Number for Brookside Manor Llc is 1457476640 and holds a License No. 00045096 (Illinois).

The current practice location address for Brookside Manor Llc is 1740 W Mccord St, Centralia, IL and can be reached out via phone at 618-532-2428 and via fax at 618-532-8305.

Location: 1740 W Mccord St, Centralia, IL, 62801-5808
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1457476640
Provider Name
Brookside Manor Llc
Credential
Provider Entity Type
Organization
Address
1740 W Mccord St, Centralia, IL, 62801-5808
Phone Number
618-532-2428
Fax Number
618-532-8305
Provider Enumeration Date
03/20/2007
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
1740 W Mccord St
City
Centralia
State
Illinois
Zip
62801-5808
Phone Number
618-532-2428
Fax Number
618-532-8305
person
Provider Business Mailing Address Details
Address
1740 W Mccord St
City
Centralia
State
Illinois
Zip
62801-5808
Phone Number
618-532-2428
Fax Number
618-532-8305
person
Provider's Taxonomy Details 1
Type
Nursing & Custodial Care Facilities
Classification
Nursing Facility/Intermediate Care Facility
Speciality
-
Taxonomy
313M00000X
License No.
00045096 (Illinois)
Definition
An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals.
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