Brookside Manor LLC
NPI 1457476640ActiveOrganization· Nursing Facility/Intermediate Care Facility· Centralia, IL
Nursing Facility/Intermediate Care Facility in Centralia, Illinois, registered in NPPES in March 2007. The authorized official on file is Lisa Middleton, Administrator.
Overview
| NPI | 1457476640 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Mar 20, 2007 |
| Last updated in NPPES | Aug 22, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nursing Facility/Intermediate Care Facility Primary | 313M00000X | 00045096 | IL |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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