Brookside Manor LLC
Brookside Manor LLC is a healthcare organization registered as Nursing Facility/Intermediate Care Facility in Centralia, IL, holding Type 2 (organization) NPI 1457476640 since 2007. The authorized official on file is Lisa Middleton, Administrator.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1457476640 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Brookside Manor LLC |
| Practice address | 1740 W MCCORD ST, Centralia, IL, 62801 |
| Phone | 6185322428 |
| Fax | 6185328305 |
| Enumeration date | 2007-03-20 |
| Last updated in NPPES | 2020-08-22 |
Authorized official
| Name | Lisa Middleton |
|---|---|
| Title | Administrator |
| Phone | 6185322428 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 313M00000X | Nursing Facility/Intermediate Care Facility | Primary | 00045096 | IL |
Copy-ready billing details
Provider: Brookside Manor LLC NPI: 1457476640 Taxonomy: 313M00000X (Nursing Facility/Intermediate Care Facility) Address: 1740 W MCCORD ST, Centralia, IL, 62801
Verify this record
Cross-check NPI 1457476640 against the authoritative CMS record: view Brookside Manor LLC on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
What is a Type 2 NPI?
What type of organization is Brookside Manor LLC?
Source: CMS NPPES (public data). Snapshot 2026-07-10. Provider record last updated 2020-08-22.