AVISTON COUNTRYSIDE MANOR
NPI 1104814490
Skilled Nursing Facility in Aviston, IL

Active since October 11, 2005CLIA 14D0716871 · Waiver
3/5
Overall Rating
450 W 1ST ST, AVISTON, IL 62216(618) 228-7615(618) 228-7632 Get Directions Write a Review

NPPES record last updated: March 18, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 28, 2020, Apr 30, 2019 (2 updates tracked since 2019).

About Aviston Countryside Manor NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

AVISTON COUNTRYSIDE MANOR (NPI 1104814490) is a healthcare organization registered as a skilled nursing facility in Aviston, Illinois and active in the NPI registry since October 2005. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists Michael Jason Mills, Cfo, as its authorized official.

NPPES Registry Identity

NPI1104814490
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NamePALLADIAN AVISTON SNF LLC
Location Address450 W 1ST STAviston, IL 62216-3440
Mailing Address1670 Essex Way Ste BO Fallon, IL 62269-3063 · (618) 327-3064 · Fax (618) 327-3083
Fax(618) 228-7632
Organization SubpartNo
Authorized OfficialMichael Jason MillsCfo · (314) 566-0459
Enumeration DateOctober 11, 2005
Last NPPES UpdateMarch 18, 20242 updates tracked since enumeration
NPPES CertifiedMarch 18, 2024
NPI 1104814490 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
License Licensed in IL · 1621197
Definition
(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.
450 W 1ST ST, Aviston, IL 62216

Other Names 1

Doing Business AsAviston Countryside Manor

Other Identifiers 1

Medicaid3712129346221601IL

Accepted Insurance

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 14D0716871

Aviston Countryside Manor · Aviston, IL
Active · expires Aug 31, 2026
CLIA Number14D0716871
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorLinda Boulware
Laboratory Phone(618) 228-7615
Laboratory LocationAviston Countryside Manor450 W 1st Street, Aviston, IL 62216
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Nursing Home Quality Ratings CMS Care Compare

Quality ratings, staffing and inspection history for Aviston Countryside Manor (CMS certification number 145601), from CMS Care Compare.

Aviston Countryside Manor

Nursing home · Aviston, IL
3/5 CMS Overall Rating
OwnershipFor profit - Corporation
CMS Certification Number145601
Certified Beds97 beds59 residents per day on average
Medicare & Medicaid Participant SinceDecember 12, 1988
Resident & Family CouncilResident council
Automatic sprinkler system

CMS Star Ratings

Quality Measures
Based on a select set of clinical quality measures.
3/5
Long-Stay Quality
Quality of care delivered to long-term residents.
3/5
Short-Stay Quality
Quality of care delivered to short-term and rehabilitation residents.
2/5
Staffing
Based on nursing staff hours relative to resident needs.
1/5
Weighted Health Inspection Score
Lower scores are better; the score summarizes deficiencies found on recent inspections.
60.33
Ratings are assigned by CMS on a one-to-five star scale; five is the highest. Categories without a current CMS rating are not shown.

Staffing & Turnover

Total Nurse Staffing
nurse aide 1.54 · LPN 0.6 · RN 0.49
2.63 hrs per resident per day
Weekend Nurse Staffing
2.35 hrs per resident per day
Physical Therapist Staffing
0 hrs per resident per day
Nursing Staff Turnover
Share of nursing staff who left the facility within the past year.
63.1%
Registered Nurse Turnover
70%
Administrators Who Have Left
In the past year.
0
Higher staffing hours generally allow more direct care time per resident.

Inspections & Enforcement

Facility-Reported Incidents
0
Substantiated Complaints
6
Fines
2 totaling $108,318.35
Medicare Payment Denials
0
Total Penalties
2
Counts come from CMS inspections and complaint investigations over approximately the past three years. CMS Care Compare data as of October 1, 2024.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Occupational Therapist
450 W 1ST ST
AVISTON, IL 62216
Social Worker (Clinical)
450 W 1ST ST
AVISTON, IL 62216
Physical Therapist
450 W 1ST ST
AVISTON, IL 62216

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Palladian Aviston Snf LLC's NPI number?

The NPI number for Palladian Aviston Snf LLC is 1104814490. It was assigned to this organization in the NPPES registry on October 11, 2005. The provider is doing business as Aviston Countryside Manor.

Where is Palladian Aviston Snf LLC located?

Palladian Aviston Snf LLC is located at 450 W 1st St, Aviston, IL 62216. The listed phone number is (618) 228-7615.

What is Palladian Aviston Snf LLC's specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.

Does Palladian Aviston Snf LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D0716871) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

Is Palladian Aviston Snf LLC a Medicare-certified nursing home?

Yes. Aviston Countryside Manor is a Medicare-certified nursing home with 97 certified beds.

What quality rating does Palladian Aviston Snf LLC have?

CMS rates Aviston Countryside Manor 3 out of 5 stars overall on Care Compare. The full measure detail is in the Nursing Home Quality Ratings section above.

What insurance does Palladian Aviston Snf LLC accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Home State Health list Palladian Aviston Snf LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Palladian Aviston Snf LLC was last updated on March 18, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.