ALDEN ESTATES OF COUNTRYSIDE INC. NPI 1023677184

NPI Information

NPI: 1023677184
Provider Name: ALDEN ESTATES OF COUNTRYSIDE, INC.
Classification: Clinic/Center - 261QR0401X
Specialization: Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
Entity Type: Organization
CLIA Number: 52D0392917
Address: 1130 COLLINS RD
JEFFERSON, WI
ZIP 53549
Phone: (920) 674-3170

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NPI Details

ALDEN ESTATES OF COUNTRYSIDE, INC. is a rehabilitation and comprehensive outpatient rehabilitation facility (corf) clinic center in Jefferson, WI. ALDEN ESTATES OF COUNTRYSIDE, INC. NPI is 1023677184. The provider is registered as an organization entity type.

The provider's business location address is:

1130 COLLINS RD
JEFFERSON, WI
ZIP 53549-939
Phone: (920) 674-3170

The provider's authorized official is John Avelino .
The authorized official title is Accounts Receivable Manager and has the following contact phone number (773) 724-6376.

The CLIA number assigned to this NPI record is 52D0392917 - skilled nursing facility/nursing facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/11/2019 and was last updated on 6/11/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QR0401X	Clinic/Center	Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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