HERITAGE WOODS OF BATAVIA I NPI 1578757696

NPI Information

NPI: 1578757696
Provider Name: HERITAGE WOODS OF BATAVIA I
Classification: Assisted Living Facility - 310400000X
Entity Type: Organization

CLIA Number: 14D2198405

Address:
1079 E WILSON ST
BATAVIA, IL
ZIP 60510
Phone: (630) 406-9440
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HERITAGE WOODS OF BATAVIA I is an assisted living facility in Batavia, IL. The provider is 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. HERITAGE WOODS OF BATAVIA I NPI is 1578757696. The provider is registered as an organization entity type.

The provider's business location address is:

1079 E WILSON ST
BATAVIA, IL
ZIP 60510-479
Phone: (630) 406-9440
Fax: (630) 406-9451

The provider's authorized official is Craig Alan Copper .
The authorized official title is Admiistrator and has the following contact phone number (630) 406-9440.

The CLIA number assigned to this NPI record is 14D2198405 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/31/2007 and was last updated on 4/20/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	310400000X	Assisted Living Facility			ILLINOIS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	=========6051001	MEDICAID	ILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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