Alden Estates of Countryside, Inc.

Primary specialty

Comprehensive Outpatient Rehabilitation Facility (CORF)Taxonomy code 261QR0401X

Legal business name

ALDEN ESTATES OF COUNTRYSIDE, INC.

Practice address

1130 Collins Rd
Jefferson, WI 53549-2939

Phone

(920) 674-3170

NPI assigned

Jun 11, 2019

Last updated

Jun 11, 2019By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

John Avelino

Title

Accounts Receivable Manager

Phone

(773) 724-6376

Specialties & licenses 1

Addresses

Tax ID family

Alden Estates of Countryside2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Alden Estates of Countryside, Inc.

  • Skilled Nursing Facility
  • Jefferson, WI
  • NPI 1285958298
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1560211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560211200000",
    "number": "1023677184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 W PETERSON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606466074",
            "telephone_number": "773-724-6376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 COLLINS RD",
            "city": "JEFFERSON",
            "state": "WI",
            "postal_code": "535492939",
            "telephone_number": "920-674-3170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALDEN ESTATES OF COUNTRYSIDE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-11",
        "last_updated": "2019-06-11",
        "status": "A",
        "authorized_official_last_name": "AVELINO",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "ACCOUNTS RECEIVABLE MANAGER",
        "authorized_official_telephone_number": "773-724-6376"
    },
    "taxonomies": [
        {
            "code": "261QR0401X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jenna Aalsma
• Jerad Adams, BS
• Suma John Adappur
• Affinity Integral Health Services
• Alden Estates of Countryside, Inc.
• Dominic Charles Alvarez, MSCJ
• Jodi Lynn Alwin, RN
• Area Dental Jefferson, LLC (Area Dental Associates, LLC)
• Sean Arient, MSW

• Comprehensive Outpatient Rehabilitation Facility (CORF) in Jefferson, WI
• Providers in Jefferson, WI by specialty
• Comprehensive Outpatient Rehabilitation Facility (CORF) in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.