Hickory Estates

LBN: Hickory Estates
Hickory Estates is an health care organization with primary practice located at 310 Otha Street , Sumner IL 62466-0164. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded, which is considered as the primary health care specialty. Hickory Estates can be contacted via phone (618) 936-2004, or through Narish, Peter Michael via phone (618) 936-2004.

Contact Information

Primary practice address
310 Otha Street Sumner IL 62466-0164
Phone: (618) 936-2004
Fax: (618) 936-2556
Website:
Map and Directions
Authorized official contact:
Name: Narish, Peter Michael ADMINISTRATOR
Phone: (618) 936-2004

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded 315P00000X 0030510 Illinois

Profile Details

NPI number 1013182807
LBN Legal business name Hickory Estates
DBA Doing business as
Authorized official Narish, Peter Michael ADMINISTRATOR
Entity Organization
Organization subpart 1 No
Enumeration date Apr 23rd, 2008
Last updated Apr 23rd, 2008 - about 16 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 1013182807 NPPES
Illinois MEDICAID 14G105

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