Heritage Manor Staunton LLC

NPI #1629069331 in Staunton, Illinois

Provider Information

NPI Number
1629069331
Entity Type
Organization
Organization Name
Heritage Manor Staunton LLC
Subpart
Yes (part of a larger organization)
Parent Organization
HERITAGE ENTERPRISES, INC
Primary Specialty
Skilled Nursing Facility
Enumeration Date
Nov 2, 2005
Last Updated
Apr 4, 2016

Practice Location

Address
215 W PENNSYLVANIA ST
ZIP Code
62088-1127
Phone
(618) 635-5577

Authorized Official

Name
MR. DAVID M UNDERWOOD
Title
SR. VP & CFO
Phone
(309) 828-4361

Specialties & Taxonomy Codes

Specialty
Skilled Nursing Facility

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