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LINCOLN TRAIL PLACE LIMITED PARTERNERSHIP NPI 1639513963


NPI Information

NPI: 1639513963
Provider Name: LINCOLN TRAIL PLACE LIMITED PARTERNERSHIP

Doing Business As: HERITAGE WOODS OF CHARLESTON

Classification: Assisted Living Facility - 310400000X
Entity Type: Organization

CLIA Number: 14D2196289

Address:
480 W POLK AVE
CHARLESTON, IL
ZIP 61920
Phone: (217) 345-4900
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LINCOLN TRAIL PLACE LIMITED PARTERNERSHIP is an assisted living facility in Charleston, 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. LINCOLN TRAIL PLACE LIMITED PARTERNERSHIP NPI is 1639513963. The provider is registered as an organization entity type.
The provider Is Doing Business As Heritage Woods Of Charleston.

The provider's business location address is:

480 W POLK AVE
CHARLESTON, IL
ZIP 61920-291
Phone: (217) 345-4900
Fax: (217) 345-4904

The provider's authorized official is Glenn Gentry .
The authorized official title is Administrator and has the following contact phone number (217) 345-4900.

The CLIA number assigned to this NPI record is 14D2196289 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/17/2013 and was last updated on 4/17/2013.


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
1310400000XAssisted Living FacilityYes

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

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