Petersen Health Enterprises LLC
Skilled Nursing Facility in Tuscola, IL. Organization (NPI-2).
NPI number1497906648
StatusActive
Last updated in NPPESOct 7, 2008
Details
- NPI
- 1497906648
- Entity type
- Organization (NPI-2)
- Legal business name
- Petersen Health Enterprises LLC
- Organization subpart
- No
- Enumeration date
- Oct 7, 2008
- Last updated
- Oct 7, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 314000000X | Skilled Nursing Facility | 0046805 | IL | Yes |
Other names
- Tuscola Rehabilitation & Health Care Center (Doing Business As)
Practice location
1203 Egyptian TrlTuscola, IL 61953-2050
Phone 217-253-4791
Mailing address
830 W Trailcreek DrPeoria, IL 61614-1862
Phone 309-691-8113
Authorized official
Mark Petersen
Manager
3096918113
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