Heritage Manor - Walnut, LLC
Organization Active NPI Skilled Nursing Facility · Walnut, IL
NPI 1861483307 · NPPES record last updated Jan 12, 2016
Key facts
- NPI
- 1861483307
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 0015784 (IL)
- Legal business name
- HERITAGE MANOR - WALNUT, LLC
- Practice address
- 308 S 2ND St
Walnut, IL 61376-9363 - Phone
- (815) 379-2131
- Fax
- (815) 379-2235
- NPI assigned
- Nov 3, 2005
- Organization subpart
- Yes
- Parent organization (as reported)
- HERITAGE ENTERPRISES, INC
Authorized official
- Name
- Mr. David M Underwood
- Title
- Sr. VP & Cfo
- Phone
- (309) 823-7135
National Provider Directory
- Part of
- Heritage Enterprises Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 0015784 | IL | Yes |
Addresses
Primary practice location
308 S 2ND St
Walnut, IL 61376-9363
Mailing address
115 W Jefferson St
Suite 401
Bloomington, IL 61701-3946
Phone (309) 828-4361
Other names
- Heritage Health
Other providers in Walnut, IL
- Katie C Edwards
- Daniel B Fuertges
- Carolyn Jean Gale
- Linda L Grant
- Heritage Manor - Walnut, LLC
- Dean A Hulsing
- Colton Ronald Johnson
- Julia Rackley Perry Memorial Hospital
- Julia Rackley Perry Memorial Hospital
- Aspen Quadri
All providers in Walnut, 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 Jan 12, 2016. 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.