COUNTRYSIDE CARE CENTER LLC
NPI 1538996038
Skilled Nursing Facility in Macomb, IL
About Countryside Care Center Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
COUNTRYSIDE CARE CENTER LLC (NPI 1538996038) is a healthcare organization registered as a skilled nursing facility in Macomb, Illinois and active in the NPI registry since September 2024. The organization holds a CLIA Waiver certificate valid through May 4, 2027 and lists Benjamin Friedman, Cfo, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
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 14D0646794
Countryside Care Center LLC · Macomb, ILOther Providers at the Same Location NPPES 4
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Care Center LLC's NPI number?
The NPI number for Countryside Care Center LLC is 1538996038. It was assigned to this organization in the NPPES registry on September 18, 2024.
Where is Countryside Care Center LLC located?
Countryside Care Center LLC is located at 400 W Grant St, Macomb, IL 61455. The listed phone number is (309) 837-2386.
What is Countryside Care Center LLC's specialty?
The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.
Does Countryside Care Center LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 14D0646794) is associated with this NPI, valid through May 4, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Countryside Care Center LLC was last updated on September 18, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months 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.