Heritage Woods of Moline Supportive Living Facility, LP

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

HERITAGE WOODS OF MOLINE SUPPORTIVE LIVING FACILITY, LP

Doing business as

Heritage Woods of Moline

Practice address

5500 46TH Avenue Dr
Moline, IL 61265-9760

Phone

(309) 736-5655

Fax

(309) 736-5651

NPI assigned

Dec 15, 2008

Last updated

Dec 15, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. D. Eileen Moseley, RN, PN, LNHA

Title

Administrator

Phone

(309) 736-5655

Specialties & licenses 1

Addresses

Other names 1

• Heritage Woods of Moline Doing business as

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": "1229299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1229299200000",
    "number": "1689819955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 46TH AVENUE DR",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612659760",
            "telephone_number": "309-736-5655",
            "fax_number": "309-736-5651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 46TH AVENUE DR",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612659760",
            "telephone_number": "309-736-5655",
            "fax_number": "309-736-5651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERITAGE WOODS OF MOLINE SUPPORTIVE LIVING FACILITY, LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-15",
        "last_updated": "2008-12-15",
        "status": "A",
        "authorized_official_last_name": "MOSELEY",
        "authorized_official_first_name": "D.",
        "authorized_official_middle_name": "EILEEN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "309-736-5655",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN, PN, LNHA"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heritage Woods of Moline",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michelle Lee Heitz, DPT
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• Richard Roland Herzfeldt, DDS
• Highland Park CVS LLC (CVS Pharmacy #16348)

• Assisted Living Facility in Moline, IL
• Providers in Moline, 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 Dec 15, 2008; 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.