| NPI | LastName | FirstName | MidName | Organization | Mailing Address | City | State | Zip |
| 1093059701 | HERITAGE MANOR - CARLINVILLE, LLC | 115 W JEFFERSON ST | BLOOMINGTON | IL | 617013946 | |||
| 1477703882 | HERITAGE MANOR - CARLINVILLE, L.L.C. | 115 W JEFFERSON ST | BLOOMINGTON | IL | 617013946 | |||
| 1831180892 | HERITAGE MANOR CARLINVILLE, LLC | 115 W JEFFERSON ST | BLOOMINGTON | IL | 617013946 |