Provider Demographics
NPI:1225194483
Name:BROOKDALE SENIOR LIVING COMMUNITIES, INC.
Entity Type:Organization
Organization Name:BROOKDALE SENIOR LIVING COMMUNITIES, INC.
Other - Org Name:STERLING HOUSE OF MANSFIELD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SENIOR VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOANNE
Authorized Official - Middle Name:K
Authorized Official - Last Name:LESKOWICZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-918-5000
Mailing Address - Street 1:111 WESTWOOD PL STE 400
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-5057
Mailing Address - Country:US
Mailing Address - Phone:615-221-2250
Mailing Address - Fax:
Practice Address - Street 1:1771 COUNTRY CLUB DR
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-6607
Practice Address - Country:US
Practice Address - Phone:817-477-0600
Practice Address - Fax:817-477-2223
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BROOKDALE SENIOR LIVING INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-12-29
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXF500229630Medicaid
TX000137300Medicaid