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General NPI Number Information
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NPI Number | 1982835229
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Entity Type | Organization
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Legal Business Name | HERITAGE WOODS OF SOUTH ELGIN
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Dates
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Enumeration Date | 08/04/2009
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Last Update Date | 08/04/2009
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Provider Practice Location Address
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Address Line | 700 N MCLEAN BLVD
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City | SOUTH ELGIN
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State | IL
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Zip | 60177-1429
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Country | US
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Telephone | 847-531-8360
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Fax | 847-531-8362
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Provider Business Mailing Address
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Address Line | 700 N MCLEAN BLVD
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City | SOUTH ELGIN
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State | IL
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Zip | 60177-1429
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Country | US
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Telephone | 847-531-8360
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Fax | 847-531-8362
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. GRACIE HAUSER
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Credential |
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Telephone | 847-531-8360
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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