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General NPI Number Information
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NPI Number | 1043217870
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Entity Type | Organization
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Legal Business Name | HELIA HEALTHCARE OF ENERGY, LLC
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Dates
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Enumeration Date | 07/07/2005
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Last Update Date | 02/27/2013
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Provider Practice Location Address
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Address Line | 210 COLLEGE
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City | ENERGY
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State | IL
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Zip | 62933
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Country | US
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Telephone | 618-942-7014
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Fax |
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Provider Business Mailing Address
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Address Line | 210 E COLLEGE ST
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City | ENERGY
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State | IL
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Zip | 62933-3568
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Country | US
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Telephone | 312-994-2306
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | MR. STEPHEN P. MILLER
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Credential |
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Telephone | 312-994-2306
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310500000X
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Taxonomy Name | Mental Illness Intermediate Care Facility
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License Number | 0046672
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 315P00000X
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Taxonomy Name | Intellectual Disabilities Intermediate Care Facility
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License Number | 0046672
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 0046672
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License Number State | IL
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