Organization
HERITAGE MANOR - COLFAX, LLC
Active
Other names
Heritage Enterprises, Inc. dba Heritage Manor - Colfax
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CRAIG L ATER (EXEC. VP & CFO)
(309) 828-4361
Entity
Organization
Contact information
Practice address
402 S HARRISON ST, R.R. 2, BOX 56, COLFAX, IL 61728-7536
(309) 723-2591
(309) 723-3013
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
48140
IL
332BX2000X
Oxygen Equipment & Supplies (DME)
0048140
IL
Other
Enumeration date
10/31/2005
Last updated
09/11/2010
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