Heritage Manor - Peru, LLC
Organization Active NPI Skilled Nursing Facility · Peru, IL
NPI 1013907138 · NPPES record last updated Apr 18, 2022
Key facts
- NPI
- 1013907138
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 48090 (IL)
- Legal business name
- HERITAGE MANOR - PERU, LLC
- Practice address
- 1301 21St St
Peru, IL 61354-1359 - Phone
- (815) 223-4901
- Fax
- (815) 223-6912
- NPI assigned
- Oct 28, 2005
- Organization subpart
- Yes
- Parent organization (as reported)
- HERITAGE ENTERPRISES, INC
Authorized official
- Name
- Mr. David M Underwood
- Title
- Sr. VP & Cfo
- Phone
- (309) 828-4361
National Provider Directory
- Part of
- Heritage Enterprises Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 48090 | IL | Yes |
| Oxygen Equipment & Supplies (DME) | 332BX2000X | 0048090 | IL |
Addresses
Primary practice location
1301 21St St
Peru, IL 61354-1359
Mailing address
115 W Jefferson St
Suite 401
Bloomington, IL 61701-3946
Phone (309) 828-4361
Other names
- Heritage Health - Peru
Other providers in Peru, IL
- Hanger Prosthetics & Orthotics, Inc
- Krystal C Hanson
- Diane Marie Harrod
- Health and Safety International, Inc
- Mark Alan Henry
- Heritage Manor - Peru, LLC
- Kendra Renee Herman
- Debra Herz
- Andrea Elizabeth Heslet
- Highland Park CVS LLC
All providers in Peru, IL · Skilled Nursing Facility in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 18, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.