Organization · Type 2 NPI

Heritage Manor Normal, LLC

Skilled Nursing Facility · Normal, IL

NPI number 1841281979 Active

Practice location

509 N Adelaide St
Normal, IL 61761-2422

Call (309) 452-7468 Map

Fax (309) 862-3148

Mailing address

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

Specialties and licenses

Taxonomy	Code	License
Skilled Nursing Facility Primary	314000000X	0038281 (IL)
Oxygen Equipment & Supplies (DME)	332BX2000X	0048082 (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…

12 other providers at this address

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NPI record

NPI: 1841281979
Entity type: Organization (Type 2)
Issued: Oct 28, 2005
Last updated: Jul 23, 2014
Status: Active
Subpart: Yes of Heritage Enterprises, Inc

Other names

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Heritage Health - Normal · doing business as

Authorized official

Mr. David M Underwood
Sr. VP & CFO
(309) 823-7135

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 1841281979

Heritage Manor Normal, LLC's National Provider Identifier is 1841281979, issued on Oct 28, 2005. The primary taxonomy on file is Skilled Nursing Facility (314000000X), and the practice location is in Normal, IL. The record was last updated on Jul 23, 2014.