Provider Demographics
NPI:1083864854
Name:ARC WESTLAKE VILLAGE SNF LLC
Entity Type:Organization
Organization Name:ARC WESTLAKE VILLAGE SNF LLC
Other - Org Name:BROOKDALE WESTLAKE VILLAGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SENIOR VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:LESKOWICZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-918-5332
Mailing Address - Street 1:28450 WESTLAKE VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-3880
Mailing Address - Country:US
Mailing Address - Phone:440-892-4200
Mailing Address - Fax:
Practice Address - Street 1:28450 WESTLAKE VILLAGE DR
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-3880
Practice Address - Country:US
Practice Address - Phone:440-892-4200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-29
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1991R310400000X
OH2524N314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH366373Medicare Oscar/Certification