# COUNTRYSIDE TN OPCO LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Countryside Health and Rehabilitation
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013492743
- **Authorized official:** DAVID HERSKOWITZ (CEO)
- **Authorized official phone:** (212) 444-1991

## Contact information

- **Practice address:** 3051 BUFFALO RD, LAWRENCEBURG, TN 38464-6189
- **Practice address phone:** (931) 762-7518
- **Mailing address:** 2071 FLATBUSH AVE STE 12, BROOKLYN, NY 11234-4340

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 09/28/2018
- **Last updated:** 02/08/2023