Organization
HERITAGE MANOR - PERU, LLC
Active
Parent organization
HERITAGE ENTERPRISES, INC
Other names
Heritage Health - Peru
Organization subpart
Yes
Provider details
NPI number
Legal business name
HERITAGE ENTERPRISES, INC
Authorized official
MR. DAVID M UNDERWOOD (SR. VP & CFO)
(309) 828-4361
Entity
Organization
Contact information
Practice address
1301 21ST ST, PERU, IL 61354-1359
(815) 223-4901
(815) 223-6912
Mailing address
115 W JEFFERSON ST, SUITE 401, BLOOMINGTON, IL 61701-3946
(309) 828-4361
(309) 829-9512
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
48090
IL
332BX2000X
Oxygen Equipment & Supplies (DME)
0048090
IL
Other
Enumeration date
10/28/2005
Last updated
04/18/2022
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