| NPI | 1972003721 |
|---|---|
| Doing Business As | COUNTRYSIDE CENTER FOR REHABILITATION AND NURSING |
| Entity Type | Organization |
| Authorized Contact | MICK VUJANOVIC CEO 502-667-8150 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility |
| Additional Taxonomies | 311ZA0620X Custodial Care Facility, Adult Care Home |
| 385H00000X Respite Care | |
| Enumeration Date | 2018-02-19 |
| Last Update Date | 2024-10-09 |