HERITAGE WOODS OF DWIGHT, LLC (NPI# 1528398021) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528398021 |
| Entity Type | Organization |
| Organization Name | HERITAGE WOODS OF DWIGHT, LLC |
| Practice Address |
701 E Mazon Ave Dwight IL 60420-1124 |
| Mailing Address |
701 E. Mazon Ave. Dwight IL 60420 |
| Practice Telephone | 8155849280 |
| Practice Fax Number | 8155849283 |
| Mailing Telephone | 8155849280 |
| Mailing Fax Number | 8155849283 |
| Enumeration Date | 2010-01-05 |
| Last Update Date | 2010-01-05 |
| Authorized Official Name | JILL ODOM (ADMINISTRATOR) |
| Authorized Official Telephone | 8155849280 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | Nursing & Custodial Care Facilities |
| Street Address |
701 E MAZON AVE |
| City | DWIGHT |
| State | IL |
| Zip Code | 60420-1124 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902149982 | Maulin G Shah | Family Medicine | 107 Watters Dr, Dwight, IL 60420 | 2013-03-28 |
| 1558446633 | Highland Park Cvs, L.l.c | Durable Medical Equipment & Medical Supplies | 106 Watters Dr, Dwight, IL 60420 | 2006-10-26 |
| 1861598997 | Cynthia Ann Humbert | Dentist | 413 E Mazon Ave, Dwight, IL 60420 | 2006-09-16 |
| 1851404313 | Mark A Passerman | Family Medicine | 101 S Prairie Ave, Dwight, IL 60420 | 2006-08-17 |
| 1528174489 | Bradford R Egly | Podiatrist | 108 W Main St, Dwight, IL 60420 | 2006-08-22 |
| 1558820829 | Laura E Lamere | Occupational Therapy Assistant | 215 E North St, Dwight, IL 60420-1051 | 2019-03-17 |
| 1982695029 | Heritage Manor Dwight, LLC | Durable Medical Equipment & Medical Supplies | 300 E Mazon Ave, Dwight, IL 60420-1104 | 2005-10-28 |
| 1194280024 | Matthew J Govednik | Physical Therapy Assistant | 300 E Mazon Ave, Dwight, IL 60420-1104 | 2019-02-05 |
| 1215346036 | Kelly Martin | Occupational Therapist | 300 E Mazon Ave, Dwight, IL 60420-1104 | 2014-08-06 |
| 1487061974 | Debra Wilder | Physical Therapy Assistant | 300 E Mazon Ave, Dwight, IL 60420-1104 | 2014-07-16 |
| Find all providers in zip 60420 | ||||
| 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 |
|---|---|---|---|---|
| 1871190504 | The Manor At Jerseyville Glen, Lp | Assisted Living Facility | 904b Estates Dr, Jerseyville, IL 62052-2377 | 2020-10-06 |
| 1861008872 | Franciscan Communities, Inc. | Assisted Living Facility | 15624 Marian Dr, Homer Glen, IL 60491-6271 | 2020-09-16 |
| 1447865118 | Oakley Courts Assisted Living Community | Assisted Living Facility | 3117 W Kunkle Blvd, Freeport, IL 61032-6943 | 2020-09-10 |
| 1083233076 | Marley Oaks Assisted Living Residence | Assisted Living Facility | 12631 187th St, Mokena, IL 60448-8731 | 2020-04-10 |
| 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 |
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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.