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HICKORY ESTATES OF TAYLORVILLE, LLC
NPI 1235688003
Assisted Living Facility in Taylorville, IL

Active since September 22, 2016CLIA 14D2208129 · Waiver
1091 E 1500 NORTH RD, TAYLORVILLE, IL 62568(217) 824-3355(217) 824-3375 Get Directions Write a Review

NPPES record last updated: September 22, 2016. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Hickory Estates Of Taylorville, Llc NPPES

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

HICKORY ESTATES OF TAYLORVILLE, LLC (NPI 1235688003) is a healthcare organization registered as an assisted living facility in Taylorville, Illinois and active in the NPI registry since September 2016. The organization holds a CLIA Waiver certificate valid through January 4, 2027 and lists Marcus Paul Leach, Managing Supervisor, as its authorized official.

NPPES Registry Identity

NPI1235688003
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameHICKORY ESTATES OF TAYLORVILLE, LLC
Location Address1091 E 1500 NORTH RDTaylorville, IL 62568-9500
Mailing Address1091 E 1500 North RdTaylorville, IL 62568-9500 · (217) 824-3355 · Fax (217) 824-3375
Phone(217) 824-3355
Fax(217) 824-3375
Organization SubpartYesParent: Christian County Integrated Community Services
Authorized OfficialMarcus Paul LeachManaging Supervisor · (217) 824-3355
Enumeration DateSeptember 22, 2016
✔ NPI 1235688003 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.
1091 E 1500 NORTH RD, Taylorville, IL 62568
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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 14D2208129

Hickory Estates Of Taylorville · Taylorville, IL
Active · expires Jan 4, 2027
CLIA Number14D2208129
Laboratory TypeAssisted Living Facility
Certificate Effective DateJanuary 5, 2025
Certificate Expiration DateJanuary 4, 2027
Laboratory DirectorMelissa Denton
Laboratory Phone(217) 824-3355
Laboratory LocationHickory Estates Of Taylorville1091 E 1500 N Rd, Taylorville, IL 62568
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

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

EMPOWERME REHABILITATION ILLINOIS, LLC
Clinic/Center (Rehabilitation)
1091 E 1500 NORTH RD
TAYLORVILLE, IL 62568
Christian County (877) 367-9772

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 Hickory Estates Of Taylorville, LLC's NPI number?

The NPI number for Hickory Estates Of Taylorville, LLC is 1235688003. It was assigned to this organization in the NPPES registry on September 22, 2016.

Where is Hickory Estates Of Taylorville, LLC located?

Hickory Estates Of Taylorville, LLC is located at 1091 E 1500 North Rd, Taylorville, IL 62568. The listed phone number is (217) 824-3355.

What is Hickory Estates Of Taylorville, LLC's specialty?

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

Does Hickory Estates Of Taylorville, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D2208129) is associated with this NPI, valid through January 4, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Hickory Estates Of Taylorville, LLC was last updated on September 22, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.