HERITAGE WOODS OF CHARLESTON
NPI 1639513963
Assisted Living Facility in Charleston, IL

Q: What is Lincoln Trail Place Limited Parternership's specialty?

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

Active since April 17, 2013CLIA 14D2196289 · Waiver

480 W POLK AVE, CHARLESTON, IL 61920(217) 345-4900(217) 345-4904 Get Directions Write a Review

NPPES record last updated: April 17, 2013. Verified against the NPPES registry weekly; last sync: November 08, 2026.

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About Heritage Woods Of Charleston NPPES

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

HERITAGE WOODS OF CHARLESTON (NPI 1639513963) is a healthcare organization registered as an assisted living facility in Charleston, Illinois and active in the NPI registry since April 2013. The organization holds a CLIA Waiver certificate valid through October 14, 2028 and lists Glenn Gentry, Administrator, as its authorized official.

NPPES Registry Identity

NPI1639513963

Entity TypeOrganization

Primary Taxonomy310400000X

Legal Business NameLINCOLN TRAIL PLACE LIMITED PARTERNERSHIP

Location Address480 W POLK AVECharleston, IL 61920-3291

Mailing Address480 W Polk AveCharleston, IL 61920-3291 · (217) 345-4900 · Fax (217) 345-4904

Phone(217) 345-4900

Fax(217) 345-4904

Organization SubpartNo

Authorized OfficialGlenn GentryAdministrator · (217) 345-4900

Enumeration DateApril 17, 2013

✔ NPI 1639513963 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.

480 W POLK AVE, Charleston, IL 61920

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Other Names 1

Doing Business AsHeritage Woods Of Charleston

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 14D2196289

Heritage Woods Of Charleston · Charleston, IL

Active · expires Oct 14, 2028

CLIA Number14D2196289

Laboratory TypeAssisted Living Facility

Certificate Effective DateOctober 15, 2026

Certificate Expiration DateOctober 14, 2028

Laboratory DirectorHeather Kress

Laboratory Phone(217) 345-4900

Laboratory LocationHeritage Woods Of Charleston480 W Polk Ave, Charleston, IL 61920

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.

JESSICA NICOLE KISTLER OTR

Occupational Therapist

480 W POLK AVE
CHARLESTON, IL 61920

Coles County (618) 231-1877

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 Lincoln Trail Place Limited Parternership's NPI number?

The NPI number for Lincoln Trail Place Limited Parternership is 1639513963. It was assigned to this organization in the NPPES registry on April 17, 2013. The provider is doing business as Heritage Woods Of Charleston.

Where is Lincoln Trail Place Limited Parternership located?

Lincoln Trail Place Limited Parternership is located at 480 W Polk Ave, Charleston, IL 61920. The listed phone number is (217) 345-4900.

What is Lincoln Trail Place Limited Parternership's specialty?

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

Does Lincoln Trail Place Limited Parternership hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D2196289) is associated with this NPI, valid through October 14, 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 Lincoln Trail Place Limited Parternership was last updated on April 17, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.