NPIMap

Organization Active NPI

Brookdale Senior Living Communities, Inc.

  • Assisted Living Facility
  • Texarkana, TX
National Provider Identifier
1487710679
Registry record updated Aug 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
BROOKDALE SENIOR LIVING COMMUNITIES, INC.
Practice address
4204 Moores LN
Texarkana, TX 75503-2198
Phone
(903) 838-3562
Fax
(903) 832-8787
NPI assigned
Dec 29, 2006
Organization subpart
Yes
Parent organization
BROOKDALE SENIOR LIVING INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 31, 2020

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

Authorized official

Name
Joanne K Leskowicz
Title
Senior Vice President
Phone
(414) 918-5000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Primary

Addresses

Primary practice location

4204 Moores LN
Texarkana, TX 75503-2198

Mailing address

111 Westwood PL Ste 400
Brentwood, TN 37027-5057
Phone (615) 221-2250

Other identifiers 1

IdentifierTypeStateIssuer
F500153420MedicaidTX

Other names 1

  • Brookdale Texarkana Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2193217Brookdale Texarkana4204 Moores Lane, Texarkana, TX 75503Certificate of waiverSep 17, 2026

National Provider Directory

National Provider Directory
Tax ID family
Brookdale Senior Living Communties Inc248 organizations share this tax ID, including this one
Part of
Brookdale Senior Living Inc

Organizations with this tax ID in the same state 19

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598832000000",
    "number": "1487710679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 WESTWOOD PL STE 400",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370275057",
            "telephone_number": "615-221-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4204 MOORES LN",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755032198",
            "telephone_number": "903-838-3562",
            "fax_number": "903-832-8787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKDALE SENIOR LIVING COMMUNITIES, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BROOKDALE SENIOR LIVING INC",
        "enumeration_date": "2006-12-29",
        "last_updated": "2020-08-31",
        "certification_date": "2020-08-31",
        "status": "A",
        "authorized_official_last_name": "LESKOWICZ",
        "authorized_official_first_name": "JOANNE",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT",
        "authorized_official_telephone_number": "414-918-5000"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "F500153420",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brookdale Texarkana",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Texarkana, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.