ATRIUM COUNTRYSIDE LLC NPI 1497753834

NPI Information

  • NPI: 1497753834
  • Provider Name: ATRIUM COUNTRYSIDE LLC
  • Classification: Assisted Living Facility - 310400000X
  • Entity Type: Organization
  • Doing Business As: COUNTRYSIDE NURSING AND REHABILITATION COMMUNITY
  • Address: 120 BASELINE RD
    SOUTH HAVEN, MI
    ZIP 49090
  • Phone: (269) 637-8411

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NPI Details

ATRIUM COUNTRYSIDE LLC is an assisted living facility in South Haven, MI. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. ATRIUM COUNTRYSIDE LLC NPI is 1497753834. The provider is registered as an organization entity type.
The provider Is Doing Business As Countryside Nursing And Rehabilitation Community.

The provider's business location address is:

120 BASELINE RD
SOUTH HAVEN, MI
ZIP 49090-037
Phone: (269) 637-8411
Fax: (269) 637-8460

The provider's authorized official is Dennis Lockhart .
The authorized official title is Chief Accounting Officer and has the following contact phone number (614) 416-0600.

The enumeration date for this NPI number is 7/11/2005 and was last updated on 2/13/2014.

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
1314000000XSkilled Nursing Facility80-4050MICHIGANNo
2310400000XAssisted Living FacilityAH800236748MICHIGANYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
123-5573MEDICARE ID-TYPE UNSPECIFIEDMICHIGAN
260 4191457MEDICAIDMICHIGAN
3S 9517OTHERMICHIGANBCBS PROVIDER CODE

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: 11/21/2025

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