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Organization

LINCOLN TRAIL PLACE LIMITED PARTERNERSHIP

Active
Other names
Heritage Woods of Charleston
Organization subpart
No

Provider details

NPI number
Authorized official
MR. GLENN GENTRY (ADMINISTRATOR)
(217) 345-4900
Entity
Organization

Contact information

Practice address
480 W POLK AVE, CHARLESTON, IL 61920-3291
(217) 345-4900
(217) 345-4904
Mailing address
480 W POLK AVE, CHARLESTON, IL 61920-3291
(217) 345-4900
(217) 345-4904

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary

Other

Enumeration date
04/17/2013
Last updated
04/17/2013
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