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Organization

HERITAGE MANOR - MT. ZION, LLC

Active
Other names
Heritage Health - Mt. Zion
Organization subpart
No

Provider details

NPI number
Authorized official
MR. DAVID M UNDERWOOD (SR. VP & CFO)
(309) 828-4361
Entity
Organization

Contact information

Practice address
1225 WOODLAND DR, MT ZION, IL 62549-1237
(217) 864-2356
(217) 864-4960
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
48074
IL
332BX2000X
Oxygen Equipment & Supplies (DME)
0048074
IL

Other

Enumeration date
10/31/2005
Last updated
03/16/2022
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