Evergreen Place Beardstown LLC
Organization Active NPI Assisted Living Facility · Beardstown, IL
NPI 1063974418 · NPPES record last updated Apr 4, 2019
Key facts
- NPI
- 1063974418
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Assisted Living Facility 310400000X
- Legal business name
- EVERGREEN PLACE BEARDSTOWN LLC
- Practice address
- 8570 Saint Lukes Dr
Beardstown, IL 62618-9200 - Phone
- (217) 323-1860
- NPI assigned
- Apr 4, 2019
- Organization subpart
- Yes
- Parent organization (as reported)
- HERITAGE ENTERPRISES, INC.
Authorized official
- Name
- David M Underwood
- Title
- Exec VP Finance & Cfo
- Phone
- (309) 823-7135
National Provider Directory
- Part of
- Heritage Enterprises Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | Yes |
Addresses
Primary practice location
8570 Saint Lukes Dr
Beardstown, IL 62618-9200
Mailing address
115 W Jefferson St Ste 401
Bloomington, IL 61701-3967
Phone (309) 823-7139
Other names
- Evergreen Place
Other providers in Beardstown, IL
- Courtney Brooke Elliott
- Cynthia J Elliott
- Kadie Lee Ellner
- Michael David Elmore
- Callie Jo Estes
- Brenda Eyler
- Diana Feigl
- Hailey Nicole Feigl
- Cari Flowers
- Foot and Ankle Associates of Central Illinois LLC
All providers in Beardstown, IL · Assisted Living 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 4, 2019. 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.