HERITAGE HEALTH - MENDOTA
NPI 1871583906
Skilled Nursing Facility in Mendota, IL

Active since October 28, 2005
1201 1ST AVE, MENDOTA, IL 61342(815) 539-6745(815) 538-2017 Get Directions Write a Review

NPPES record last updated: May 27, 2014. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Heritage Health - Mendota NPPES

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

HERITAGE HEALTH - MENDOTA (NPI 1871583906) is a healthcare organization registered as a skilled nursing facility in Mendota, Illinois and active in the NPI registry since October 2005. The organization lists David M Underwood, Sr. Vp & Cfo, as its authorized official.

NPPES Registry Identity

NPI1871583906
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameHERITAGE MANOR MENDOTA, LLC
Location Address1201 1ST AVEMendota, IL 61342-1815
Mailing Address115 W Jefferson St, Suite 401Bloomington, IL 61701-3946 · (309) 828-4361 · Fax (309) 829-9512
Fax(815) 538-2017
Organization SubpartYesParent: Heritage Enterprises, Inc
Authorized OfficialDavid M UnderwoodSr. Vp & Cfo · (309) 828-4361
Enumeration DateOctober 28, 2005
Last NPPES UpdateMay 27, 2014
NPI 1871583906 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 · 48108
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 0048108 (IL)
1201 1ST AVE, Mendota, IL 61342

Other Names 1

Doing Business AsHeritage Health - Mendota

Other Identifiers 3

Medicaid=========001IL
Medicare OSCAR/certification145151IL
Other=========-801IL · Medicaid Oxygen Provider

Other Providers at the Same Location NPPES 5

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

Durable Medical Equipment & Medical Supplies (Oxygen Equipment & Supplies)
1201 1ST AVE
MENDOTA, IL 61342
Occupational Therapy Assistant
1201 1ST AVE
MENDOTA, IL 61342
Skilled Nursing Facility
1201 1ST AVE
MENDOTA, IL 61342
Durable Medical Equipment & Medical Supplies (Oxygen Equipment & Supplies)
1201 1ST AVE
MENDOTA, IL 61342
Occupational Therapist
1201 1ST AVE
MENDOTA, IL 61342

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 Mendota, LLC's NPI number?

The NPI number for Heritage Manor Mendota, LLC is 1871583906. It was assigned to this organization in the NPPES registry on October 28, 2005. The provider is doing business as Heritage Health - Mendota.

Where is Heritage Manor Mendota, LLC located?

Heritage Manor Mendota, LLC is located at 1201 1st Ave, Mendota, IL 61342. The listed phone number is (815) 539-6745.

What is Heritage Manor Mendota, LLC's specialty?

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

When was this NPI record last updated?

The NPPES record for Heritage Manor Mendota, LLC was last updated on May 27, 2014. NPI Profile syncs with the weekly NPPES data releases published by CMS.