Organization · Type 2 NPI

Heritage Manor - El Paso, LLC

Skilled Nursing Facility · El Paso, IL

NPI number 1093706137 Active

Practice location

555 E Clay St
El Paso, IL 61738-1508

Call (309) 527-6240 Map

Fax (309) 527-6243

Mailing address

115 W Jefferson St, Suite 401
Bloomington, IL 61701-3946

Specialties and licenses

Taxonomy	Code	License
Skilled Nursing Facility Primary	314000000X	48124 (IL)
Oxygen Equipment & Supplies (DME)	332BX2000X	0048124 (IL)

Skilled Nursing Facility: (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to r…

4 other providers at this address

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NPI record

NPI: 1093706137
Entity type: Organization (Type 2)
Issued: Oct 28, 2005
Last updated: Apr 6, 2022
Status: Active
Subpart: Yes of Heritage Enterprises, Inc

Other names

<unavail>
Heritage Health - El Paso · doing business as
Heritage Health - El Paso · doing business as

Authorized official

Mr. David M Underwood
Sr. VP & CFO
(309) 828-4361

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1093706137

Heritage Manor - El Paso, LLC's National Provider Identifier is 1093706137, issued on Oct 28, 2005. The primary taxonomy on file is Skilled Nursing Facility (314000000X), and the practice location is in El Paso, IL. The record was last updated on Apr 6, 2022.