Emericare Countryside Village LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

EMERICARE COUNTRYSIDE VILLAGE LLC

Doing business as

Brookdale Easley

Practice address

706 Pelzer Hwy
Easley, SC 29642-2941

Phone

(864) 859-0167

NPI assigned

May 14, 2015

Organization subpart

Yes

Parent organization

BROOKDALE SENIOR LIVING INC.As reported in NPPES

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

Authorized official

Name

Mark Ohlendorf

Title

Cfo

Phone

(414) 918-5000

Specialties & licenses 1

Addresses

Other names 1

• Brookdale Easley Doing business as

Part of

Brookdale Senior Living Inc

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

{
    "created_epoch": "1431561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431561600000",
    "number": "1588042188",
    "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": "706 PELZER HWY",
            "city": "EASLEY",
            "state": "SC",
            "postal_code": "296422941",
            "telephone_number": "864-859-0167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMERICARE COUNTRYSIDE VILLAGE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BROOKDALE SENIOR LIVING INC.",
        "enumeration_date": "2015-05-14",
        "last_updated": "2015-05-14",
        "status": "A",
        "authorized_official_last_name": "OHLENDORF",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "414-918-5000"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brookdale Easley",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kimberly Chew Ellison, APRN, FNP-BC
• Lena Renee Elrod, LPC-A
• Ember ABA and Pediatric Therapy, LLC
• Emerald Transport Services, LLC
• Emericare Countryside Village LLC (Brookdale Easley)
• Emericare Inc (Countryside Health Care Center)
• Emeritus Corporation (Brookdale Easley)
• Emeritus Corporation (Brookdale Easley)
• Linlee Engdahl
• Deborah Ennis, LICSW, LISW-CP

• Skilled Nursing Facility in Easley, SC
• Providers in Easley, SC by specialty
• Skilled Nursing Facility in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 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.