MINOOKA SUPPORTIVE LIVING FACILITY, LLC (NPI# 1831634146) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831634146 |
| Entity Type | Organization |
| Organization Name | MINOOKA SUPPORTIVE LIVING FACILITY, LLC |
| Other Organization Name | HERITAGE WOODS OF MINOOKA |
| Practice Address |
701 Heritage Woods Dr Minooka IL 60447-8281 |
| Practice Telephone | 8154672837 |
| Practice Fax Number | 8154672783 |
| Mailing Telephone | 8154672837 |
| Mailing Fax Number | 8154672783 |
| Enumeration Date | 2016-12-21 |
| Last Update Date | 2016-12-21 |
| Authorized Official Name | JOELLEN BLEAVINS (PRESIDENT OF MANAGEMENT AGENT) |
| Authorized Official Telephone | 8159351992 |
| 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 Minooka | Doing Business As Name - Organization |
| Street Address |
701 HERITAGE WOODS DR |
| City | MINOOKA |
| State | IL |
| Zip Code | 60447-8281 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598253296 | Laura Ann Viita | Occupational Therapist | 701 Heritage Woods Dr, Minooka, IL 60447-8284 | 2018-04-27 |
| 1487177135 | Laurie Kirkolis | Occupational Therapist | 701 Heritage Woods Dr, Minooka, IL 60447-8281 | 2017-07-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326538596 | Wanda Hardy Perkins | Social Worker | 203 W Mondamin St, Minooka, IL 60447 | 2018-05-14 |
| 1629597729 | Jennifer Praveen | Psychologist | 333 Mcevilly Rd, Minooka, IL 60447 | 2017-09-11 |
| 1013164193 | Carrie Ann Skubic | Counselor | 113 W. Wapella St., Suite 2, Minooka, IL 60447 | 2008-08-20 |
| 1164624680 | Minooka Comm Hs Dist 111 | Local Education Agency (LEA) | 203 W Mondamin, Minooka, IL 60447 | 2007-06-05 |
| 1710196191 | Ridge Dental Group, Ltd | Dentist | 2003 Ridge Road, Minooka, IL 60447 | 2007-05-22 |
| 1629109020 | James Dale Mcgehee | Dentist | 123 Mondamin Street, Minooka, IL 60447 | 2007-03-08 |
| 1073554341 | Minooka Fire Protection District | Ambulance | 413 W Mondamin, Minooka, IL 60447 | 2006-06-09 |
| 1639110612 | Angela Solis | Counselor | 113 West Wapella Street, Suite 2, Minooka, IL 60447 | 2006-06-09 |
| 1811944366 | American Drug Stores LLC | Durable Medical Equipment & Medical Supplies | 2051 Ridge Rd, Minooka, IL 60447 | 2006-05-30 |
| 1427205111 | Crossroads Counseling Services, LLC | Counselor | 113 W. Wapella St., Suite 2, Minooka, IL 60447 | 2008-08-25 |
| Find all providers in zip 60447 | ||||
| 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 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on MINOOKA SUPPORTIVE LIVING FACILITY, LLC.
| 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.