Provider Demographics
NPI:1912457953
Name:ALEGRIA LIVING & HEALTHCARE, INC
Entity Type:Organization
Organization Name:ALEGRIA LIVING & HEALTHCARE, INC
Other - Org Name:BROOKSIDE ASSISTED LIVING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:G
Authorized Official - Last Name:AVERILL
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:785-224-3453
Mailing Address - Street 1:702 W 7TH ST
Mailing Address - Street 2:
Mailing Address - City:OVERBROOK
Mailing Address - State:KS
Mailing Address - Zip Code:66524-9496
Mailing Address - Country:US
Mailing Address - Phone:785-665-7124
Mailing Address - Fax:866-936-9557
Practice Address - Street 1:702 W 7TH ST
Practice Address - Street 2:
Practice Address - City:OVERBROOK
Practice Address - State:KS
Practice Address - Zip Code:66524-9496
Practice Address - Country:US
Practice Address - Phone:785-665-7124
Practice Address - Fax:866-936-9557
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALEGRIA LIVING & HEALTHCARE, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-10-13
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility