Heritage Manor Normal, LLC

NPI #1841281979 in Normal, Illinois

Provider Information

NPI Number
1841281979
Entity Type
Organization
Organization Name
Heritage Manor Normal, LLC
Subpart
Yes (part of a larger organization)
Parent Organization
HERITAGE ENTERPRISES, INC
Primary Specialty
Skilled Nursing Facility
Enumeration Date
Oct 28, 2005
Last Updated
Jul 23, 2014

Practice Location

Address
509 N ADELAIDE ST
City
Normal
ZIP Code
61761-2422
Phone
(309) 452-7468

Authorized Official

Name
MR. DAVID M UNDERWOOD
Title
SR. VP & CFO
Phone
(309) 823-7135

Specialties & Taxonomy Codes

Specialty
Durable Medical Equipment & Medical Supplies - Oxygen Equipment & SuppliesOxygen Equipment & Supplies
Skilled Nursing Facility

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