Decatur Manor Healthcare, Llc

LBN: Decatur Manor Healthcare, Llc
Decatur Manor Healthcare, Llc is an health care organization with primary practice located at 1016 W Pershing Rd , Decatur IL 62526-1541. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Intermediate Care Facility, Mental Illness, which is considered as the primary health care specialty. Decatur Manor Healthcare, Llc can be contacted via phone (217) 875-0833, or through Winter, Thomas via phone (847) 675-7979.

Contact Information

Primary practice address
1016 W Pershing Rd Decatur IL 62526-1541
Phone: (217) 875-0833
Fax: (217) 875-6851
Website:
Map and Directions
Authorized official contact:
Name: Winter, Thomas CPA
Phone: (847) 675-7979

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Intermediate Care Facility, Mental Illness 310500000X
Nursing & Custodial Care Facilities / Intermediate Care Facility, Mental Illness 310500000X 0049262 Illinois

Profile Details

NPI number 1134126063
LBN Legal business name Decatur Manor Healthcare, Llc
DBA Doing business as
Authorized official Winter, Thomas CPA
Entity Organization
Organization subpart 1 No
Enumeration date Jul 7th, 2005
Last updated Sep 9th, 2013 - about 12 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134126063 NPPES
Illinois MEDICAID 612731133
Illinois MEDICAID 370969602
Illinois MEDICAID 31CX5

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