Arc Countryside, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

ARC COUNTRYSIDE, LLC

Doing business as

Brookdale Countryside

Practice address

3260 N McMullen Booth Rd
Clearwater, FL 33761-2040

Phone

(727) 726-5090

Fax

(727) 723-0808

NPI assigned

Nov 17, 2010

Organization subpart

No

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

Authorized official

Name

Mark Ohlendorf

Title

President

Phone

(414) 918-5000

Specialties & licenses 1

Addresses

Other names 1

• Brookdale Countryside Doing business as

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

{
    "created_epoch": "1289952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441670400000",
    "number": "1396046728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6737 W WASHINGTON ST",
            "address_2": "SUITE 2300",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532145647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3260 N MCMULLEN BOOTH RD",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337612040",
            "telephone_number": "727-726-5090",
            "fax_number": "727-723-0808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARC COUNTRYSIDE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-17",
        "last_updated": "2015-09-08",
        "status": "A",
        "authorized_official_last_name": "OHLENDORF",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "414-918-5000"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brookdale Countryside",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Alexa Rose Appugliese
• Hector Alejandro Arango, MD
• Aravilla Clearwater
• Elizabeth Marjorie Arboleda, M.D.
• Victor Arboleda, M.D.
• Gabrielle Kenyon Arevalo
• Ashley Arflack
• Victoria Argueta
• Jacqueline Armstead, COMM. HEALTH WORKER
• Terence Alan Armstead, MPT

• Assisted Living Facility in Clearwater, FL
• Providers in Clearwater, FL by specialty
• Assisted Living Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2015; 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.