HERITAGE HEALTH - PERU
NPI 1013907138
Skilled Nursing Facility in Peru, IL

Active since October 28, 2005CLIA 14D0681827 · Waiver
1301 21ST ST, PERU, IL 61354(815) 223-4901(815) 223-6912 Get Directions Write a Review

NPPES record last updated: April 18, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Heritage Health - Peru NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

HERITAGE HEALTH - PERU (NPI 1013907138) is a healthcare organization registered as a skilled nursing facility in Peru, Illinois and active in the NPI registry since October 2005. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists David M Underwood, Sr. Vp & Cfo, as its authorized official.

NPPES Registry Identity

NPI1013907138
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameHERITAGE MANOR - PERU, LLC
Location Address1301 21ST STPeru, IL 61354-1359
Mailing Address115 W Jefferson St, Suite 401Bloomington, IL 61701-3946 · (309) 828-4361 · Fax (309) 829-9512
Fax(815) 223-6912
Organization SubpartYesParent: Heritage Enterprises, Inc
Authorized OfficialDavid M UnderwoodSr. Vp & Cfo · (309) 828-4361
Enumeration DateOctober 28, 2005
Last NPPES UpdateApril 18, 2022
NPPES CertifiedApril 18, 2022
NPI 1013907138 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
License Licensed in IL · 48090
Definition
(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.
Also ListedDurable Medical Equipment & Medical Supplies · Oxygen Equipment & SuppliesTaxonomy 332BX2000X · License 0048090 (IL)
1301 21ST ST, Peru, IL 61354

Other Names 1

Doing Business AsHeritage Health - Peru

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 14D0681827

Heritage Manor Peru L L C · Peru, IL
Active · expires Aug 31, 2026
CLIA Number14D0681827
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorAllison Ciesielski
Laboratory Phone(815) 223-4901
Laboratory LocationHeritage Manor Peru L L C1301 21st Street, Peru, IL 61354
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Physical Therapy Assistant
1301 21ST ST
PERU, IL 61354
Durable Medical Equipment & Medical Supplies (Oxygen Equipment & Supplies)
1301 21ST ST
PERU, IL 61354
Skilled Nursing Facility
1301 21ST ST
PERU, IL 61354
Occupational Therapy Assistant
1301 21ST ST
PERU, IL 61354
Physical Therapy Assistant
1301 21ST ST
PERU, IL 61354
Physical Therapist
1301 21ST ST
PERU, IL 61354
Durable Medical Equipment & Medical Supplies (Oxygen Equipment & Supplies)
1301 21ST ST
PERU, IL 61354

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Heritage Manor - Peru, LLC's NPI number?

The NPI number for Heritage Manor - Peru, LLC is 1013907138. It was assigned to this organization in the NPPES registry on October 28, 2005. The provider is doing business as Heritage Health - Peru.

Where is Heritage Manor - Peru, LLC located?

Heritage Manor - Peru, LLC is located at 1301 21st St, Peru, IL 61354. The listed phone number is (815) 223-4901.

What is Heritage Manor - Peru, LLC's specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.

Does Heritage Manor - Peru, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D0681827) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Heritage Manor - Peru, LLC was last updated on April 18, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.