Healthcare Provider Details

I. General information

NPI: 1730254095
Provider Name (Legal Business Name): HELIA HEALTHCARE OF SALEM LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2006
Last Update Date: 03/18/2024
Certification Date: 03/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 HAWTHORN RD
SALEM IL
62881-1028
US

IV. Provider business mailing address

500 NW PLAZA DR STE 712
SAINT ANN MO
63074-2222
US

V. Phone/Fax

Practice location:
  • Phone: 618-548-4884
  • Fax: 618-548-4884
Mailing address:
  • Phone: 314-317-2003
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. MICHAEL JASON MILLS
Title or Position: CFO
Credential:
Phone: 314-317-2003