HERITAGE WOODS OF MT. VERNON, LLC
NPI 1922299858
Assisted Living Facility in Mount Vernon, IL

Active since August 06, 2007CLIA 14D2197938 · Waiver
1033 S 42ND ST, MOUNT VERNON, IL 62864(618) 241-9518(618) 241-9516 Get Directions Write a Review

NPPES record last updated: April 20, 2008. Verified against the NPPES registry weekly; last sync: July 19, 2026.

  • Organization
  • Assisted Living Facility
  • CLIA Number: 14D2197938
  • CLIA Cert. Type: Assisted Living Facility
  • CLIA Exp. Date: 10-27-2026

About HERITAGE WOODS OF MT. VERNON, LLC

This page provides the complete NPI Profile along with additional information for Heritage Woods Of Mt. Vernon, Llc, a provider established in Mount Vernon, Illinois operating as a Assisted Living Facility. The healthcare provider is registered in the NPI registry with number 1922299858 assigned on August 2007. The practitioner's primary taxonomy code is 310400000X. The provider is registered as an organization and their NPI record was last updated 18 years ago. The authorized official of this NPI record is Sarah Diane Rowland (Administrator)

NPI
1922299858 Verify this NPI
Provider Name
HERITAGE WOODS OF MT. VERNON, LLC
Entity Type
Organization
Location Address
1033 S 42ND ST MOUNT VERNON, IL 62864
Location Phone
(618) 241-9518
Location Fax
(618) 241-9516
Mailing Address
1033 S 42ND ST MOUNT VERNON, IL 62864
Mailing Phone
(618) 241-9518
Mailing Fax
(618) 241-9516
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
08-06-2007
Last Update Date
04-20-2008
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Assisted Living Facility

Taxonomy Code
310400000X
Type
Nursing & Custodial Care Facilities
Taxonomy Description
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.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

SARAH DIANE ROWLAND

Authorized Official Title
ADMINISTRATOR
Authorized Official Phone
(618) 241-9518

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
=========001MEDICAID (05)IL 

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
14D2197938
Facility Type
Assisted Living Facility
Certificate Effective Date
October 28, 2024
Certificate Expiration Date
October 27, 2026
Laboratory Director
MICHELE L. ROLLA
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Heritage Woods Of Mt. Vernon, Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

Reviews for HERITAGE WOODS OF MT. VERNON, LLC

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Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1922299858, enumerated as an "organization" on August 06, 2007.

The provider is located at 1033 S 42ND ST MOUNT VERNON, IL 62864 and the phone number is (618) 241-9518.

Assisted Living Facility with taxonomy code 310400000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.