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HERITAGE ENTERPRISES INC. NPI 1710156609


NPI Information

NPI: 1710156609
Provider Name: HERITAGE ENTERPRISES, INC.

Doing Business As: EVERGREEN PLACE SUPPORTIVE LIVING FACILITY

Classification: Assisted Living Facility - 310400000X
Entity Type: Organization
Address:
8570 SAINT LUKES DR
BEARDSTOWN, IL
ZIP 62618
Phone: (217) 323-4055
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HERITAGE ENTERPRISES, INC. is an assisted living facility in Beardstown, 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. HERITAGE ENTERPRISES, INC. NPI is 1710156609. The provider is registered as an organization entity type.
The provider Is Doing Business As Evergreen Place Supportive Living Facility.

The provider's business location address is:

8570 SAINT LUKES DR
BEARDSTOWN, IL
ZIP 62618-200
Phone: (217) 323-4055
Fax: (217) 323-9454

The provider's authorized official is Craig L Ater .
The authorized official title is Senior V. P. Of Finance and has the following contact phone number (309) 823-7135.

The enumeration date for this NPI number is 2/25/2008 and was last updated on 4/20/2008.


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 Facility1825445ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1=========028MEDICAIDILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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