GURNEE SUPPORTIVE LIVING LP NPI 1669726527

NPI Information

  • NPI: 1669726527
  • Provider Name: GURNEE SUPPORTIVE LIVING, LP
  • Classification: Assisted Living Facility - 310400000X
  • Entity Type: Organization
  • Doing Business As: HERITAGE WOODS OF GURNEE
  • CLIA Number: 14D2197259
  • Address: 3775 GRAND AVE
    GURNEE, IL
    ZIP 60031
  • Phone: (847) 623-6300

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NPI Details

GURNEE SUPPORTIVE LIVING, LP is an assisted living facility in Gurnee, IL. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. GURNEE SUPPORTIVE LIVING, LP NPI is 1669726527. The provider is registered as an organization entity type.
The provider Is Doing Business As Heritage Woods Of Gurnee.

The provider's business location address is:

3775 GRAND AVE
GURNEE, IL
ZIP 60031-910
Phone: (847) 623-6300
Fax: (847) 623-6305

The provider's authorized official is Keri Horn .
The authorized official title is Regional Director Of Operations and has the following contact phone number (847) 623-6300.

The CLIA number assigned to this NPI record is 14D2197259 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/30/2012 and was last updated on 10/30/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1310400000XAssisted Living FacilityYes

What is NPI?

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This page was last updated on: 11/21/2025

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