MINOOKA SUPPORTIVE LIVING FACILITY LLC NPI 1831634146

NPI Information

  • NPI: 1831634146
  • Provider Name: MINOOKA SUPPORTIVE LIVING FACILITY, LLC
  • Classification: Assisted Living Facility - 310400000X
  • Entity Type: Organization
  • Doing Business As: HERITAGE WOODS OF MINOOKA
  • CLIA Number: 14D2196060
  • Address: 701 HERITAGE WOODS DR
    MINOOKA, IL
    ZIP 60447
  • Phone: (815) 467-2837

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NPI Details

MINOOKA SUPPORTIVE LIVING FACILITY, LLC is an assisted living facility in Minooka, 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. MINOOKA SUPPORTIVE LIVING FACILITY, LLC NPI is 1831634146. The provider is registered as an organization entity type.
The provider Is Doing Business As Heritage Woods Of Minooka.

The provider's business location address is:

701 HERITAGE WOODS DR
MINOOKA, IL
ZIP 60447-281
Phone: (815) 467-2837
Fax: (815) 467-2783

The provider's authorized official is Joellen Bleavins .
The authorized official title is President Of Management Agent and has the following contact phone number (815) 935-1992.

The CLIA number assigned to this NPI record is 14D2196060 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/21/2016 and was last updated on 12/21/2016.

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?

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: 11/21/2025

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