1. Home
  2. Directory
  3. Ohio
  4. Fremont
  5. Skilled Nursing Facility
  6. NPI Profile

COUNTRYSIDE MANOR NURSING AND REHABILITATION LLC
NPI 1952887549
Skilled Nursing Facility in Fremont, OH

Active since July 17, 2018CLIA 36D0723403 · Waiver
2/5
Overall Rating
1865 COUNTRYSIDE DR, FREMONT, OH 43420(419) 334-2602(419) 344-6287 Get Directions Write a Review

NPPES record last updated: July 17, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Countryside Manor Nursing And Rehabilitation Llc NPPES

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

COUNTRYSIDE MANOR NURSING AND REHABILITATION LLC (NPI 1952887549) is a healthcare organization registered as a skilled nursing facility in Fremont, Ohio and active in the NPI registry since July 2018. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists Hayley Williams, Attorney, as its authorized official.

NPPES Registry Identity

NPI1952887549
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameCOUNTRYSIDE MANOR NURSING AND REHABILITATION LLC
Location Address1865 COUNTRYSIDE DRFremont, OH 43420-8748
Mailing Address15 America Ave Unit 304Lakewood, NJ 08701-4582 · (513) 487-7479
Phone(419) 334-2602
Fax(419) 344-6287
Organization SubpartNo
Authorized OfficialHayley WilliamsAttorney · (216) 706-3936
Enumeration DateJuly 17, 2018
✔ NPI 1952887549 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 OH · 2362N
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.
1865 COUNTRYSIDE DR, Fremont, OH 43420
Open in Google Maps ↗

Other Identifiers 1

Other2362NOH · Licensure

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.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 36D0723403

Countryside Manor Nursing And Rehab LLC · Fremont, OH
Active · expires Aug 31, 2026
CLIA Number36D0723403
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorRugen Alden
Laboratory Phone(419) 334-2602
Laboratory LocationCountryside Manor Nursing And Rehab LLC1865 Countryside Drive, Fremont, OH 43420
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 Countryside Manor Nursing And Rehabilitation LLC (CMS certification number 365418), from CMS Care Compare.

Countryside Manor Nursing And Rehabilitation LLC

Nursing home · Fremont, OH
2/5 CMS Overall Rating
OwnershipFor profit - Corporation
CMS Certification Number365418
Certified Beds82 beds67 residents per day on average
Medicare & Medicaid Participant SinceMay 29, 1979
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.
4/5
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.
3/5
Weighted Health Inspection Score
Lower scores are better; the score summarizes deficiencies found on recent inspections.
80.83
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 2.05 · LPN 1.19 · RN 0.65
3.9 hrs per resident per day
Weekend Nurse Staffing
3.49 hrs per resident per day
Physical Therapist Staffing
0.06 hrs per resident per day
Nursing Staff Turnover
Share of nursing staff who left the facility within the past year.
80.5%
Registered Nurse Turnover
28.6%
Administrators Who Have Left
In the past year.
1
Higher staffing hours generally allow more direct care time per resident.

Inspections & Enforcement

Facility-Reported Incidents
0
Substantiated Complaints
6
Fines
1 totaling $15,592.85
Medicare Payment Denials
0
Total Penalties
1
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 4

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

LIBERTY NURSING CENTER OF FREMONT, INC
Skilled Nursing Facility (Nursing Care, Pediatric)
1865 COUNTRYSIDE DR
FREMONT, OH 43420
Sandusky County (419) 334-2602
COUNTRYSIDE CONTINUING CARE
Skilled Nursing Facility
1865 COUNTRYSIDE DR
FREMONT, OH 43420
Sandusky County (419) 334-2602
PRISTINE SENIOR LIVING OF FREMONT, LLC
Skilled Nursing Facility
1865 COUNTRYSIDE DR
FREMONT, OH 43420
Sandusky County (419) 334-2602
LARRY J HILL SLP
Speech-Language Pathologist
1865 COUNTRYSIDE DR
FREMONT, OH 43420
Sandusky County (419) 334-2602

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 Nursing And Rehabilitation LLC's NPI number?

The NPI number for Countryside Manor Nursing And Rehabilitation LLC is 1952887549. It was assigned to this organization in the NPPES registry on July 17, 2018.

Where is Countryside Manor Nursing And Rehabilitation LLC located?

Countryside Manor Nursing And Rehabilitation LLC is located at 1865 Countryside Dr, Fremont, OH 43420. The listed phone number is (419) 334-2602.

What is Countryside Manor Nursing And Rehabilitation LLC's specialty?

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

Does Countryside Manor Nursing And Rehabilitation LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 36D0723403) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

Is Countryside Manor Nursing And Rehabilitation LLC a Medicare-certified nursing home?

Yes. Countryside Manor Nursing And Rehabilitation LLC is a Medicare-certified nursing home with 82 certified beds.

What quality rating does Countryside Manor Nursing And Rehabilitation LLC have?

CMS rates Countryside Manor Nursing And Rehabilitation LLC 2 out of 5 stars overall on Care Compare. The full measure detail is in the Nursing Home Quality Ratings section above.

What insurance does Countryside Manor Nursing And Rehabilitation LLC accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and CareSource list Countryside Manor Nursing And Rehabilitation 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 Countryside Manor Nursing And Rehabilitation LLC was last updated on July 17, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.