Heritage Manor - Lasalle, LLC
NPI #1366786444 in Bloomington, Illinois
Provider Information
- NPI Number
- 1366786444
- Entity Type
- Organization
- Organization Name
- Heritage Manor - Lasalle, LLC
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- HERITAGE ENTERPRISES, INC
- Primary Specialty
- Durable Medical Equipment & Medical Supplies - Oxygen Equipment & Supplies
- Enumeration Date
- Nov 15, 2012
- Last Updated
- Nov 15, 2012
Practice Location
- Address
- 115 W JEFFERSON ST
- Address 2
- SUITE 401
- City
- Bloomington
- State
- Illinois
- ZIP Code
- 61701-3946
- Phone
- (309) 828-4361
Authorized Official
- Name
- CRAIG L ATER, CPA
- Title
- EXEC VP
- Phone
- (309) 823-7135
Specialties & Taxonomy Codes
| Specialty |
|---|
| Durable Medical Equipment & Medical Supplies - Oxygen Equipment & Supplies — Oxygen Equipment & Supplies |
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