Organization · Type 2 NPI

Heritage Manor Carlinville, LLC

Skilled Nursing Facility · Carlinville, IL

NPI number 1831180892 Active

Practice location

1200 University Ave.
Carlinville, IL 62626-9600

Call (217) 854-4433 Map

Fax (217) 854-6291

Mailing address

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

Specialties and licenses

Taxonomy	Code	License
Skilled Nursing Facility Primary	314000000X	048850 (IL)
Oxygen Equipment & Supplies (DME)	332BX2000X	0048850 (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…

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NPI record

NPI: 1831180892
Entity type: Organization (Type 2)
Issued: Oct 31, 2005
Last updated: May 27, 2014
Status: Active
Subpart: Yes of Heritage Enterprises, Inc

Other names

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Heritage Health - Carlinville · doing business as

Authorized official

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

Verify this record

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 1831180892

Heritage Manor Carlinville, LLC's National Provider Identifier is 1831180892, issued on Oct 31, 2005. The primary taxonomy on file is Skilled Nursing Facility (314000000X), and the practice location is in Carlinville, IL. The record was last updated on May 27, 2014.