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Organization

MINOOKA SUPPORTIVE LIVING FACILITY, LLC

Active
Other names
Heritage Woods of Minooka
Organization subpart
No

Provider details

NPI number
Authorized official
JOELLEN BLEAVINS (PRESIDENT OF MANAGEMENT AGENT)
(815) 935-1992
Entity
Organization

Contact information

Practice address
701 HERITAGE WOODS DR, MINOOKA, IL 60447-8281
(815) 467-2837
(815) 467-2783
Mailing address
701 HERITAGE WOODS DR, MINOOKA, IL 60447-8281
(815) 467-2837
(815) 467-2783

Taxonomy

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

Other

Enumeration date
12/21/2016
Last updated
12/21/2016
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