# COUNTRYSIDE HEALTH SERVICES, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Countryside Estates, Inc.
- **Organization subpart:** No

## Provider details

- **NPI number:** 1336252089
- **Authorized official:** JOHN ERIC ROGERS (MEMBER)
- **Authorized official phone:** (918) 404-3443

## Contact information

- **Practice address:** HIGHWAY 64 EAST, WARNER, OK 74469-0749
- **Practice address phone:** (918) 463-5143
- **Practice address fax:** (918) 463-5144
- **Mailing address:** PO BOX 749, WARNER, OK 74469-0749
- **Mailing address phone:** (918) 463-5143
- **Mailing address fax:** (918) 463-5144

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 313M00000X | Nursing Facility/Intermediate Care Facility | NH51025102 | OK | Yes |

## Other

- **Enumeration date:** 08/16/2006
- **Last updated:** 01/08/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 200073790A | — | OK |