NPIMap

Organization Active NPI

Brookdale Senior Living Communities Inc

  • Assisted Living Facility
  • Canton, OH
National Provider Identifier
1689901563
Registry record updated Nov 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
2197R Issued in OH
Legal business name
BROOKDALE SENIOR LIVING COMMUNITIES INC
Practice address
1119 Perry Dr NW
Canton, OH 44708-3374
Phone
(330) 479-1121
Fax
(330) 479-1756
NPI assigned
Nov 12, 2009
Organization subpart
Yes
Parent organization
BROOKDALE SENIOR LIVING INCAs reported in NPPES

Authorized official

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

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
36D0971937Brookdale Canton1119 Perry Drive NW, Canton, OH 44708Certificate of waiverJan 3, 2027

National Provider Directory

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

Corporate family (same tax ID) 21

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

View all 21

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 2197R OH Primary

Addresses

NPPES NPI Registry

Primary practice location

1119 Perry Dr NW
Canton, OH 44708-3374

Mailing address

1119 Perry Dr NW
Canton, OH 44708-3374
Phone (330) 479-1121

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
3042184MedicaidOH

Other names 1

NPPES NPI Registry
  • Brookdale Canton Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 17, 2020.

{
    "created_epoch": "1257984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605571200000",
    "number": "1689901563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1119 PERRY DR NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447083374",
            "telephone_number": "330-479-1121",
            "fax_number": "330-479-1756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1119 PERRY DR NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447083374",
            "telephone_number": "330-479-1121",
            "fax_number": "330-479-1756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKDALE SENIOR LIVING COMMUNITIES INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BROOKDALE SENIOR LIVING INC",
        "enumeration_date": "2009-11-12",
        "last_updated": "2020-11-17",
        "certification_date": "2020-11-17",
        "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": "OH",
            "license": "2197R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3042184",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brookdale Canton",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Canton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 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.