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FOXES GROVE SUPPORTING LIVING
NPI 1114461175
Assisted Living Facility in Wood River, IL

Active since December 10, 2016CLIA 14D2299448 · Waiver
395 E EDWARDSVILLE RD, WOOD RIVER, IL 62095(618) 259-0851 Get Directions Write a Review

NPPES record last updated: June 25, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jun 25, 2021, Jan 26, 2021 (2 updates tracked since 2021).

About Foxes Grove Supporting Living NPPES

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

FOXES GROVE SUPPORTING LIVING (NPI 1114461175) is a healthcare organization registered as an assisted living facility in Wood River, Illinois and active in the NPI registry since December 2016. The organization holds a CLIA Waiver certificate valid through February 20, 2028 and lists James Mason, President, as its authorized official.

NPPES Registry Identity

NPI1114461175
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameWOOD RIVER NH LLC
Location Address395 E EDWARDSVILLE RDWood River, IL 62095-1600
Mailing Address395 E Edwardsville RdWood River, IL 62095-1600
Phone(618) 259-0851
Organization SubpartNo
Authorized OfficialJames MasonPresident · (813) 347-7425
Enumeration DateDecember 10, 2016
Last NPPES UpdateJune 25, 20212 updates tracked since enumeration
NPPES CertifiedJune 25, 2021
✔ NPI 1114461175 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
Definition
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.
395 E EDWARDSVILLE RD, Wood River, IL 62095
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Other Names 1

Doing Business AsFoxes Grove Supporting Living

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 14D2299448

Foxes Grove Supportive Living · Wood River, IL
Active · expires Feb 20, 2028
CLIA Number14D2299448
Laboratory TypeSupportive Living Provide
Certificate Effective DateFebruary 21, 2026
Certificate Expiration DateFebruary 20, 2028
Laboratory DirectorKayla M. Wentler
Laboratory Phone(618) 259-0851
Laboratory LocationFoxes Grove Supportive Living395 E Edwardsville Rd, Wood River, IL 62095
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

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

WOOD RIVER RETIREMENT CENTER, INC
Assisted Living Facility
395 E EDWARDSVILLE RD
WOOD RIVER, IL 62095
Madison County (618) 259-0851
BRAVO CARE OF WOOD RIVER INC
Assisted Living Facility
395 E EDWARDSVILLE RD
WOOD RIVER, IL 62095
Madison County (618) 259-0851
FOXES GROVE SLP, LLC
Assisted Living Facility
395 E EDWARDSVILLE RD
WOOD RIVER, IL 62095
Madison County (618) 259-0851

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 Wood River Nh LLC's NPI number?

The NPI number for Wood River Nh LLC is 1114461175. It was assigned to this organization in the NPPES registry on December 10, 2016. The provider is doing business as Foxes Grove Supporting Living.

Where is Wood River Nh LLC located?

Wood River Nh LLC is located at 395 E Edwardsville Rd, Wood River, IL 62095. The listed phone number is (618) 259-0851.

What is Wood River Nh LLC's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Does Wood River Nh LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D2299448) is associated with this NPI, valid through February 20, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Wood River Nh LLC was last updated on June 25, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.