Hickory Estates of Taylorville, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

HICKORY ESTATES OF TAYLORVILLE, LLC

Practice address

1091 E 1500 North Rd
Taylorville, IL 62568-9500

Phone

(217) 824-3355

Fax

(217) 824-3375

NPI assigned

Sep 22, 2016

Organization subpart

Yes

Parent organization

CHRISTIAN COUNTY INTEGRATED COMMUNITY SERVICESAs reported in NPPES

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

Authorized official

Name

Mr. Marcus Paul Leach

Title

Managing Supervisor

Phone

(217) 824-3355

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1474502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474502400000",
    "number": "1235688003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1091 E 1500 NORTH RD",
            "city": "TAYLORVILLE",
            "state": "IL",
            "postal_code": "625689500",
            "telephone_number": "217-824-3355",
            "fax_number": "217-824-3375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1091 E 1500 NORTH RD",
            "city": "TAYLORVILLE",
            "state": "IL",
            "postal_code": "625689500",
            "telephone_number": "217-824-3355",
            "fax_number": "217-824-3375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HICKORY ESTATES OF TAYLORVILLE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHRISTIAN COUNTY INTEGRATED COMMUNITY SERVICES",
        "enumeration_date": "2016-09-22",
        "last_updated": "2016-09-22",
        "status": "A",
        "authorized_official_last_name": "LEACH",
        "authorized_official_first_name": "MARCUS",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "MANAGING SUPERVISOR",
        "authorized_official_telephone_number": "217-824-3355",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hear Well Hearing Care Centre
• Hearing at Home
• Hearing at Home, Inc.
• Brenda M. Hemann, NP
• Lauren A. Henton, LCSW
• High Point Residence Taylorville LLC
• Highland Park CVS, L.L.C.
• Bailee Hinds, APN
• Hospice Care of Taylorville Memorial Hospital
• Sara Howe, COTA

• Assisted Living Facility in Taylorville, IL
• Providers in Taylorville, IL by specialty
• Assisted Living Facility in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.