HERITAGE MANOR BLOOMINGTON, LLC

BLOOMINGTON, IL
NPI1457343170
Doing Business AsHERITAGE HEALTH - BLOOMINGTON
Entity TypeOrganization
Authorized ContactDAVID M UNDERWOOD
Sr. VP & CFO
309-828-4361
Organization Subpart ?Yes
Primary Taxonomy314000000X Skilled Nursing Facility
(Licence: IL  48157)
Additional Taxonomies224Z00000X Occupational Therapy Assistant
225XP0019X Occupational Therapist, Physical Rehabilitation
2251G0304X Physical Therapist, Geriatrics
225200000X Physical Therapy Assistant
235Z00000X Speech-Language Pathologist,
332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies
(Licence: IL  48157)
Enumeration Date2005-08-18
Last Update Date2014-05-27
Business Address
HERITAGE MANOR BLOOMINGTON, LLC
700 E WALNUT ST
BLOOMINGTON, IL 61701-3244
Phone number: 309-827-8004
Mailing Address
HERITAGE MANOR BLOOMINGTON, LLC
115 W JEFFERSON ST SUITE 401
BLOOMINGTON, IL 61701-3946
Phone number: 309-828-4361