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COUNTRYSIDE MANOR HEALTHCARE CENTER
NPI 1356300206
Skilled Nursing Facility - Nursing Care, Pediatric in Anderson, IN

Active since March 20, 2006
205 MARINE DR, ANDERSON, IN 46016(765) 649-4558(765) 641-1239 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Countryside Manor Healthcare Center NPPES

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

COUNTRYSIDE MANOR HEALTHCARE CENTER (NPI 1356300206) is a healthcare organization registered as a nursing care, pediatric in Anderson, Indiana and active in the NPI registry since March 2006. The organization lists Hervey Lawrence, Administrator, as its authorized official.

NPPES Registry Identity

NPI1356300206
Entity TypeOrganization
Primary Taxonomy3140N1450X
Legal Business NameCOUNTRYSIDE MANOR HEALTHCARE CENTER
Location Address205 MARINE DRAnderson, IN 46016-5937
Mailing Address205 Marine DrAnderson, IN 46016-5937 · (765) 649-4558 · Fax (765) 641-1239
Phone(765) 649-4558
Fax(765) 641-1239
Organization SubpartNo
Authorized OfficialHervey LawrenceAdministrator · (765) 649-4558
Enumeration DateMarch 20, 2006
Last NPPES UpdateAugust 22, 2020
✔ NPI 1356300206 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySkilled Nursing Facility · Nursing Care, PediatricNursing & Custodial Care Facilities
Taxonomy Code3140N1450X
Definition
A nursing care facility designed and staffed for the provision of nursing care and appropriate educational and habilitative/rehabilitative services to children with multiple, complex or profound disabilities that can not be cared for in a less restrictive environment.
205 MARINE DR, Anderson, IN 46016
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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.

ALISHA HOLMAN COTA
Occupational Therapy Assistant
205 MARINE DR
ANDERSON, IN 46016
Madison County (765) 648-2526
RIVERVIEW HOSPITAL
Skilled Nursing Facility
205 MARINE DR
ANDERSON, IN 46016
Madison County (765) 649-0455
MRS. MICHELLE LEE SANFORD M.A., CCC-SLP
Speech-Language Pathologist
205 MARINE DR
ANDERSON, IN 46016
Madison County (765) 648-2526

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 Countryside Manor Healthcare Center's NPI number?

The NPI number for Countryside Manor Healthcare Center is 1356300206. It was assigned to this organization in the NPPES registry on March 20, 2006.

Where is Countryside Manor Healthcare Center located?

Countryside Manor Healthcare Center is located at 205 Marine Dr, Anderson, IN 46016. The listed phone number is (765) 649-4558.

What is Countryside Manor Healthcare Center's specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility, specializing in Nursing Care, Pediatric, with taxonomy code 3140N1450X.

When was this NPI record last updated?

The NPPES record for Countryside Manor Healthcare Center was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.