Diversicare Leasing LP

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

N4504 Issued in AL

Legal business name

DIVERSICARE LEASING LP

Doing business as

Brookshire Healthcare Center

Practice address

4320 Judith LN SW
Huntsville, AL 35805-3363

Phone

(256) 837-1730

Fax

(256) 430-3287

NPI assigned

Oct 6, 2005

Organization subpart

Yes

Parent organization

DLC GP LLCAs reported in NPPES

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

Authorized official

Name

Matthew J. Weishaar

Title

Chief Financial Officer & Secretary

Phone

(615) 771-7575

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Brookshire Healthcare Center Doing business as

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Diversicare Leasing LP

  • Skilled Nursing Facility
  • Martin, TN
  • NPI 1538157664

  Member Of

  NPD member

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

{
    "created_epoch": "1128556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674172800000",
    "number": "1821086562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4320 JUDITH LN SW",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358053363",
            "telephone_number": "256-837-1730",
            "fax_number": "256-430-3287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4320 JUDITH LN SW",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358053363",
            "telephone_number": "256-837-1730",
            "fax_number": "256-430-3287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVERSICARE LEASING LP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DLC GP LLC",
        "enumeration_date": "2005-10-06",
        "last_updated": "2023-01-20",
        "certification_date": "2022-10-25",
        "status": "A",
        "authorized_official_last_name": "WEISHAAR",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER & SECRETARY",
        "authorized_official_telephone_number": "615-771-7575"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "AL",
            "license": "N4504",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47-57660S",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brookshire Healthcare Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Brookshire Healthcare Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Huntsville, AL
• Providers in Huntsville, AL by specialty
• Skilled Nursing Facility in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2023; 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.