Organization
HERITAGE MANOR - DANVILLE, LLC
Active
Parent organization
HERITAGE ENTERPRISES, INC
Other names
Colonial Manor
Organization subpart
Yes
Provider details
NPI number
Legal business name
HERITAGE ENTERPRISES, INC
Authorized official
DAVID M UNDERWOOD CPA (EXEC VP, CFO)
(309) 823-7135
Entity
Organization
Contact information
Practice address
620 WARRINGTON AVE, DANVILLE, IL 61832-5446
(217) 446-0660
(217) 446-9839
Mailing address
115 W JEFFERSON ST, SUITE 401, BLOOMINGTON, IL 61701-3946
(309) 828-4361
(309) 829-5477
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0053413
IL
332BX2000X
Oxygen Equipment & Supplies (DME)
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Other
Enumeration date
11/26/2012
Last updated
01/29/2016
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