OrganizationActive
Countryside Care Center LLC
NPI 1538996038 · Skilled Nursing Facility · Macomb, IL
Provider details
- NPI number
- 1538996038
- Entity type
- Organization
- Primary specialty
- Skilled Nursing FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Benjamin Friedman, Cfo(845) 414-3300
Specialties & taxonomies
Nursing & Custodial Care Facilities
Practice location
400 W Grant St
Macomb, IL 61455-2867
Phone: (309) 837-2386
Fax: (309) 836-9191
Approximate (ZIP-level) locationGet directions
Mailing address
7b Medical Park Dr
Pomona, NY 10970-3516
Registry dates
- Enumerated
- 2024-09-18
- Last updated
- 2024-09-18
- Certified
- 2024-09-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.