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COUNTRYSIDE NURSING AND REHABILITATION COMMUNITY
NPI 1497753834
Assisted Living Facility in South Haven, MI

Active since July 11, 2005
120 BASELINE RD, SOUTH HAVEN, MI 49090(269) 637-8411(269) 637-8460 Get Directions Write a Review

NPPES record last updated: February 13, 2014. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Countryside Nursing And Rehabilitation Community NPPES

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

COUNTRYSIDE NURSING AND REHABILITATION COMMUNITY (NPI 1497753834) is a healthcare organization registered as an assisted living facility in South Haven, Michigan and active in the NPI registry since July 2005. The organization lists Dennis Lockhart, Chief Accounting Officer, as its authorized official.

NPPES Registry Identity

NPI1497753834
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameATRIUM COUNTRYSIDE LLC
Location Address120 BASELINE RDSouth Haven, MI 49090-1037
Mailing Address5000 Hakes Dr, Suite 600Norton Shores, MI 49441-5574 · (231) 799-6870 · Fax (231) 799-0250
Phone(269) 637-8411
Fax(269) 637-8460
Organization SubpartNo
Authorized OfficialDennis LockhartChief Accounting Officer · (614) 416-0600
Enumeration DateJuly 11, 2005
Last NPPES UpdateFebruary 13, 2014
✔ NPI 1497753834 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
License✔ Licensed in MI · AH800236748
Definition
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.
Also ListedSkilled Nursing FacilityTaxonomy 314000000X · License 80-4050 (MI)
120 BASELINE RD, South Haven, MI 49090
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Other Names 1

Doing Business AsCountryside Nursing And Rehabilitation Community

Other Identifiers 3

Medicare ID-Type Unspecified23-5573MI
Medicaid60 4191457MI
OtherS 9517MI · Bcbs Provider Code

Other Providers at the Same Location NPPES 5

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

GRACEWAY SOUTH HAVEN, LLC
Skilled Nursing Facility
120 BASELINE RD
SOUTH HAVEN, MI 49090
Van Buren County (269) 637-8411
FRANCES SUERTE RODEN
Speech-Language Pathologist
120 BASELINE RD
SOUTH HAVEN, MI 49090
Van Buren County (269) 637-8411
SOUTH HAVEN OPCO, LLC
Skilled Nursing Facility
120 BASELINE RD
SOUTH HAVEN, MI 49090
Van Buren County (269) 637-8411
TRACY RALICKI OTR
Occupational Therapist (Gerontology)
120 BASELINE RD
SOUTH HAVEN, MI 49090
Van Buren County (269) 637-8411
WENDY BEAM
Occupational Therapist
120 BASELINE RD
SOUTH HAVEN, MI 49090
Van Buren County (269) 637-8411

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 Atrium Countryside LLC's NPI number?

The NPI number for Atrium Countryside LLC is 1497753834. It was assigned to this organization in the NPPES registry on July 11, 2005. The provider is doing business as Countryside Nursing And Rehabilitation Community.

Where is Atrium Countryside LLC located?

Atrium Countryside LLC is located at 120 Baseline Rd, South Haven, MI 49090. The listed phone number is (269) 637-8411.

What is Atrium Countryside LLC's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

When was this NPI record last updated?

The NPPES record for Atrium Countryside LLC was last updated on February 13, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.