EAGLE RIDGE OF DECATUR, LP (NPI# 1316069099) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316069099 |
| Entity Type | Organization |
| Organization Name | EAGLE RIDGE OF DECATUR, LP |
| Other Organization Name | BMA MANAGEMENT |
| Practice Address |
875 W Mckinley Ave Decatur IL 62526-3287 |
| Practice Telephone | 2178721282 |
| Practice Fax Number | 2178721227 |
| Mailing Telephone | 2178721282 |
| Mailing Fax Number | 2178721227 |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. SANDRA K BARTON (ADMINISTRATOR) |
| Authorized Official Telephone | 2178721282 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | IL | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| BMA Management | Other Name - Individual/Organization |
| Street Address |
875 W MCKINLEY AVE |
| City | DECATUR |
| State | IL |
| Zip Code | 62526-3287 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134684798 | Jessica Alyse Grunden | Occupational Therapist | 875 W Mckinley Ave, Decatur, IL 62526-3287 | 2019-02-07 |
| 1316487317 | Healthpro Heritage Rehab & Fitness, LLC | Occupational Therapist | 875 W Mckinley Ave, Decatur, IL 62526-3287 | 2017-02-24 |
| 1174751242 | Kristin Nicole Hillman | Physical Therapist | 875 W Mckinley Ave, Decatur, IL 62526-3287 | 2009-06-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083100804 | Coalition | Non-emergency Medical Transport (VAN) | 2375 N Longwood Dr, Decatur, IL 62526 | 2018-07-04 |
| 1881116820 | Bria N Howard | Nurse's Aide | 606 E Warren St. Apt 609, Decatur, IL 62526 | 2017-07-12 |
| 1437683679 | Lutheran Child and Family Services | Foster Care Agency | 2826 N. Monroe Street, Decatur, IL 62526 | 2017-04-14 |
| 1083166326 | Whitney Miller | Pharmacist | 225 East Ash Ave, Decatur, IL 62526 | 2016-11-03 |
| 1487053369 | Central Illinois Health Associates, Inc | Preferred Provider Organization | 2300 N. Edward Street, Decatur, IL 62526 | 2014-08-18 |
| 1659787893 | Stephanie Marie Kanitsch | Obstetrics & Gynecology | 544 W Pershing Rd Ste A, Decatur, IL 62526 | 2014-07-09 |
| 1497169973 | Brian Hassinger | Audiologist-Hearing Aid Fitter | 2605 N Water St Ste 101, Decatur, IL 62526 | 2014-06-12 |
| 1891041570 | Decatur 2016 LLC | Dentist | 141 Epershing Rd, Decatur, IL 62526 | 2012-07-31 |
| 1558639005 | Larry Lee Christensen | Pharmacist | 225 Ash Ave, Decatur, IL 62526 | 2011-12-12 |
| 1174821540 | Nathan Pyle | Internal Medicine | 2 Memorial Dr Ste 101, Decatur, IL 62526 | 2011-03-08 |
| Find all providers in zip 62526 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| 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. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013381235 | Altrus | Assisted Living Facility | 3363 Luxembourg Cir, Decatur, GA 30034-5418 | 2015-11-27 |
| 1013274794 | Live Oak Management, L.p. | Assisted Living Facility | 300 E Devereaux St, Decatur, TX 76234-3033 | 2012-04-18 |
| 1003188913 | Evergreen Place Decatur, LLC | Assisted Living Facility | 4825 E Evergreen Court, Decatur, IL 62521 | 2012-02-08 |
| 1952638769 | Greater Works, Inc. | Assisted Living Facility | 2551 Rainshower Dr, Decatur, GA 30034-2164 | 2009-11-16 |
| 1730373416 | Ambassador of Angels Inc. | Assisted Living Facility | 3782 Citation Dr, Decatur, GA 30034-2128 | 2007-09-05 |
| 1497893879 | Avondale Health Services Inc. | Assisted Living Facility | 3508 Kensington Rd, Decatur, GA 30032-1328 | 2007-02-01 |
| 1184662017 | Morningside of Decatur, L.p. | Assisted Living Facility | 2115 Point Mallard Dr Se, Decatur, AL 35601-6765 | 2006-06-03 |
| 1972961415 | Live Oak Holdings, LLC | Assisted Living Facility | 300 E Devereaux St, Decatur, TX 76234-3033 | 2016-01-28 |
| 1740662402 | Avondale Health Services Inc | Assisted Living Facility | 3508 Kensington Rd, Decatur, GA 30032-1328 | 2015-06-18 |
| 1851600324 | Avondale Health Services Inc. | Assisted Living Facility | 3508 Kensington Rd, Decatur, GA 30032-1328 | 2010-10-01 |
| Find all providers in DECATUR | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.