LINCOLN TRAIL PLACE LIMITED PARTERNERSHIP (NPI# 1639513963) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639513963 |
| Entity Type | Organization |
| Organization Name | LINCOLN TRAIL PLACE LIMITED PARTERNERSHIP |
| Other Organization Name | HERITAGE WOODS OF CHARLESTON |
| Practice Address |
480 W Polk Ave Charleston IL 61920-3291 |
| Practice Telephone | 2173454900 |
| Practice Fax Number | 2173454904 |
| Mailing Telephone | 2173454900 |
| Mailing Fax Number | 2173454904 |
| Enumeration Date | 2013-04-17 |
| Last Update Date | 2013-04-17 |
| Authorized Official Name | MR. GLENN GENTRY (ADMINISTRATOR) |
| Authorized Official Telephone | 2173454900 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Heritage Woods of Charleston | Doing Business As Name - Organization |
| Street Address |
480 W POLK AVE |
| City | CHARLESTON |
| State | IL |
| Zip Code | 61920-3291 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124643879 | Jenna Kay Mortensen | Speech-Language Pathologist | 2086 7th Street, Charleston, IL 61920 | 2020-06-09 |
| 1255954566 | Christina L. White | Nurse Practitioner | 1199 Persimmon Rd, Charleston, IL 61920 | 2020-05-20 |
| 1679066773 | Jennifer Hess | Specialist/Technologist | 2506 Lantz Building, Charleston, IL 61920 | 2018-06-13 |
| 1134647969 | Nichole C Ogilvie | Student in an Organized Health Care Education/Training Program | 917 4th Street Apt 19, Charleston, IL 61920 | 2017-08-31 |
| 1467970319 | Marcus Roach | Physical Therapy Assistant | 912 Oakcrest Dr. Apt D, Charleston, IL 61920 | 2017-08-30 |
| 1114478500 | 5 Guys Rx II LLC | Pharmacy | 1 W Lincoln Ave, Charleston, IL 61920 | 2016-10-20 |
| 1649723206 | Bright Minds Educational Program Inc | Developmental Therapist | 7704 Deerpath Road, Charleston, IL 61920 | 2016-08-01 |
| 1760843379 | Lisa Price | Nurse Practitioner | 2040 Lincoln Ave, Suite 100, Charleston, IL 61920 | 2016-03-09 |
| 1104243385 | Nathan David Schwartzkopf | Specialist/Technologist | 1340 A Street, Charleston, IL 61920 | 2014-03-25 |
| 1558694349 | Emily Schilling | Specialist/Technologist | 2350 Harrison Avenue, Charelston, IL 61920 | 2009-09-10 |
| Find all providers in zip 61920 | ||||
| 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 |
|---|---|---|---|---|
| 1063024156 | Snh Se Ashley River Tenant LLC | Assisted Living Facility | 2330 Ashley River Rd, Charleston, SC 29414-4752 | 2020-08-19 |
| 1942847157 | Indigo Hall Operating Co, LLC | Assisted Living Facility | 509 Standard Way, Charleston, SC 29412-2397 | 2019-12-06 |
| 1225526650 | Jonathan and Blessing LLC | Assisted Living Facility | 5312 Morning Dove Ln, Charleston, WV 25313-1154 | 2018-05-01 |
| 1386880425 | Jade Community Residential Care LLC | Assisted Living Facility | 9 Cunnington Street, Charleston, SC 29413 | 2008-12-19 |
| 1366688400 | Jade Community Residential Care LLC | Assisted Living Facility | 7a & 7b Cunnington St, Charleston, SC 29413 | 2008-12-19 |
| 1174771562 | Nhc Place-charleston LLC | Assisted Living Facility | 1900 Ashley Crossing Dr, Charleston, SC 29414-5752 | 2008-08-28 |
| 1508933854 | Charleston Alf Operations LLC | Assisted Living Facility | 699 S Park Rd, Charleston, WV 25304-2627 | 2006-11-30 |
| 1144836164 | Bkd Charleston South Carolina, LLC | Assisted Living Facility | 2030 Charlie Hall Blvd, Charleston, SC 29414-5830 | 2020-09-16 |
| 1306334750 | Blessing O Eya | Assisted Living Facility | 5312 Morning Dove Ln, Charleston, WV 25313-1154 | 2018-05-01 |
| 1841454279 | Oak Haven Senior Living | Assisted Living Facility | 2333 Ashley River Rd, Charleston, SC 29414-4755 | 2008-07-15 |
| Find all providers in CHARLESTON | ||||
| City | CHARLESTON |
| Zip Code | 61920 |
Please comment or provide details below to improve the information on LINCOLN TRAIL PLACE LIMITED PARTERNERSHIP.
| 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.