Heritage Manor - Beardstown East, L.L.C.
Organization Active NPI Skilled Nursing Facility · Beardstown, IL
NPI 1700877693 · NPPES record last updated Jun 23, 2012
Key facts
- NPI
- 1700877693
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 048835 (IL)
- Legal business name
- HERITAGE MANOR - BEARDSTOWN EAST, L.L.C.
- Practice address
- 1501 Canal St
Beardstown, IL 62618-2349 - Phone
- (217) 323-1900
- Fax
- (217) 323-1914
- NPI assigned
- Oct 31, 2005
- Organization subpart
- No
Authorized official
- Name
- Mr. Craig L Ater
- Title
- Exec. VP & Cfo
- Phone
- (309) 828-4361
Corporate family (same tax ID) 12
National Provider Directory
- Tax ID family
- Heritage Enterprises Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 048835 | IL | Yes |
| Oxygen Equipment & Supplies (DME) | 332BX2000X | 0048835 | IL |
Addresses
Primary practice location
1501 Canal St
Beardstown, IL 62618-2349
Mailing address
115 W Jefferson St
Suite 401
Bloomington, IL 61701-3946
Phone (309) 828-4361
Other names
- Heritage Enterprises, Inc. dba Heritage Manor East - Beardstown
Other providers in Beardstown, IL
- Christa M Harlan
- Harlee Harris
- Marilyn Hea
- Cassandra L Henry
- Heritage Enterprises, Inc.
- Heritage Manor - Beardstown South, LLC
- Heritage Manor Beardstown South, LLC
- Julie Kathleen Hester
- Sarah Hicks
- Sandra Jean Holmes
All providers in Beardstown, 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 Jun 23, 2012. 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.