EVERGREEN PLACE BEARDSTOWN LLC (NPI# 1063974418) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063974418 |
| Entity Type | Organization |
| Organization Name | EVERGREEN PLACE BEARDSTOWN LLC |
| Practice Address |
8570 Saint Lukes Dr Beardstown IL 62618-9200 |
| Mailing Address |
115 W Jefferson St Ste 401 Bloomington IL 61701-3967 |
| Practice Telephone | 2173231860 |
| Mailing Telephone | 3098237139 |
| Enumeration Date | 2019-04-04 |
| Last Update Date | 2019-04-04 |
| Authorized Official Name | DAVID M UNDERWOOD (EXEC VP FINANCE & CFO) |
| Authorized Official Telephone | 3098237135 |
| Is Organization Subpart | Y |
| Parent Organization Name | HERITAGE ENTERPRISES, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Evergreen Place | Doing Business As Name - Organization |
| Street Address |
8570 SAINT LUKES DR |
| City | BEARDSTOWN |
| State | IL |
| Zip Code | 62618-9200 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710156609 | Heritage Enterprises, Inc. | Assisted Living Facility | 8570 Saint Lukes Dr, Beardstown, IL 62618-9200 | 2008-02-25 |
| 1720699937 | Emily Hall | Occupational Therapy Assistant | 8570 Saint Lukes Dr, Beardstown, IL 62618-9200 | 2020-08-11 |
| 1720401557 | Rachel Merideth | Physical Therapist | 8570 Saint Lukes Dr, Beardstown, IL 62618-9200 | 2014-01-30 |
| 1942439310 | Cass County Public Health Dept | Clinic/Center | 8570 Saint Lukes Dr, Beardstown, IL 62618-9200 | 2009-07-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962646042 | Cass County Mental Health | Clinic/Center | 7 Bridgeview, Beardstown, IL 62618 | 2009-04-21 |
| 1750562195 | Pamida Stores Operating Co LLC | Durable Medical Equipment & Medical Supplies | 113 West 3rd St, Beardstown, IL 62618 | 2007-11-14 |
| 1316162993 | John Gauer Merrihew Dmd Ltd | Dentist | 1020 State St, Beardstown, IL 62618 | 2007-04-17 |
| 1942316179 | Cass County Mental Health Assoc | Clinic/Center | 121 E 2nd Street, Beardstown, IL 62618 | 2006-08-21 |
| 1619922143 | Sembu Kanthilal | Family Medicine | 507 Washington St, Beardstown, IL 62618 | 2006-05-23 |
| 1538111638 | Schuyler County Hospital District | Clinic/Center | 8460 St Lukes Dr, Beardstown, IL 62618 | 2006-05-17 |
| 1255795902 | Cass County Mental Health Association | Rehabilitation, Substance Use Disorder Unit | 121 E 2nd St, Beardstown, IL 62618 | 2016-04-08 |
| 1326282401 | Cass County Mental Health | Clinic/Center | 415 Clendenin St, Beardstown, IL 62618 | 2009-04-21 |
| 1801932728 | Diane M Morris | Counselor | 415 Clendenin St, Beardstown, IL 62618-1034 | 2007-01-29 |
| 1679002125 | Michala Nicole Swanger | Counselor | 415 Clendenin St, Beardstown, IL 62618-1034 | 2017-06-08 |
| Find all providers in zip 62618 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710156609 | Heritage Enterprises, Inc. | Assisted Living Facility | 8570 Saint Lukes Dr, Beardstown, IL 62618-9200 | 2008-02-25 |
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|---|---|---|---|---|
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| 1447884630 | Cedarhurst of Quincy Operator, LLC | Assisted Living Facility | 319 S 48th St, Quincy, IL 62305-0593 | 2020-02-26 |
| 1164055323 | Cye Sullivan Hco, LLC | Assisted Living Facility | 20 Courtyard Blvd, Sullivan, IL 61951-7001 | 2020-02-17 |
| 1255964573 | Cottages At Salem, Inc. | Assisted Living Facility | 339 S Hotze Rd, Salem, IL 62881-6858 | 2020-02-14 |
| 1841821014 | Generations At Oakton Arms, LLC | Assisted Living Facility | 1665 Oakton Pl, Des Plaines, IL 60018-6301 | 2020-01-28 |
| 1710521984 | Cottages At Carlinville, Inc | Assisted Living Facility | 18804 Rt. 4, Carlinville, IL 62626 | 2019-10-31 |
| 1275184889 | The Encore At The Twin Cities | Assisted Living Facility | 101 N Wacker Dr Ste 608, Chicago, IL 60606-1726 | 2019-09-25 |
| Find all providers with the same taxonomy | ||||
| City | BEARDSTOWN |
| Zip Code | 62618 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.