# ATRIUM CENTREVILLE LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Fairview Nursing and Rehabilitation Community, Atrium Centreville, Inc.
- **Organization subpart:** No

## Provider details

- **NPI number:** 1841298288
- **Authorized official:** DENNIS LOCKHART (CHIEF ACCOUNTING OFFICER)
- **Authorized official phone:** (614) 416-0600

## Contact information

- **Practice address:** 441 E MAIN ST, CENTREVILLE, MI 49032-9626
- **Practice address phone:** (269) 467-9575
- **Practice address fax:** (269) 467-7077
- **Mailing address:** 441 E MAIN ST, CENTREVILLE, MI 49032-9626
- **Mailing address phone:** (269) 467-9575
- **Mailing address fax:** (269) 467-7077

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 310400000X | Assisted Living Facility | AH750236782 | MI | — |
| 314000000X | Skilled Nursing Facility | 75-4010 | MI | Yes |

## Other

- **Enumeration date:** 07/11/2005
- **Last updated:** 03/03/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 09715 | BCBS PROVIDER CODE | MI |
| 05 | — | 60 3079677 | — | MI |