NPIMap

Organization Active NPI

Friendship Manor Group, LLC

Doing business as Friendship Manor Health Care

  • Skilled Nursing Facility
  • Nashville, IL
National Provider Identifier
1063659118
Registry record updated Jan 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
0050161 Issued in IL
Legal business name
FRIENDSHIP MANOR GROUP, LLC
Doing business as
Friendship Manor Health Care
Practice address
485 S Friendship Dr
Nashville, IL 62263-1363
Phone
(618) 327-3041
Fax
(618) 327-4001
NPI assigned
Jan 12, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Cathy Lietz
Title
Administrator
Phone
(618) 327-3041

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 0050161 IL Primary

Addresses

Primary practice location

485 S Friendship Dr
Nashville, IL 62263-1363

Mailing address

485 S Friendship Dr
Nashville, IL 62263-1363
Phone (618) 327-3041

Other identifiers 1

IdentifierTypeStateIssuer
1508019548OtherILLONG TERM CARE NPI #

Other names 1

  • Friendship Manor Health Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Friendship Manor Group LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1231718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231718400000",
    "number": "1063659118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "485 S FRIENDSHIP DR",
            "city": "NASHVILLE",
            "state": "IL",
            "postal_code": "622631363",
            "telephone_number": "618-327-3041",
            "fax_number": "618-327-4001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "485 S FRIENDSHIP DR",
            "city": "NASHVILLE",
            "state": "IL",
            "postal_code": "622631363",
            "telephone_number": "618-327-3041",
            "fax_number": "618-327-4001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRIENDSHIP MANOR GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-12",
        "last_updated": "2009-01-12",
        "status": "A",
        "authorized_official_last_name": "LIETZ",
        "authorized_official_first_name": "CATHY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "618-327-3041",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "0050161",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LONG TERM CARE NPI #",
            "identifier": "1508019548",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Friendship Manor Health Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Nashville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.