Royal Hco, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

0046243 Issued in IL

Legal business name

ROYAL HCO, LLC

Practice address

605 E Church St
Kewanee, IL 61443-3503

Phone

(309) 852-3389

Fax

(309) 853-1838

NPI assigned

Apr 21, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mark B. Petersen

Title

Manager

Phone

(309) 689-5880

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Royal Oaks Care Center Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1145577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605657600000",
    "number": "1194781807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 W TRAILCREEK DR",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616141862",
            "telephone_number": "309-691-8113",
            "fax_number": "309-691-8622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 E CHURCH ST",
            "city": "KEWANEE",
            "state": "IL",
            "postal_code": "614433503",
            "telephone_number": "309-852-3389",
            "fax_number": "309-853-1838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROYAL HCO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-21",
        "last_updated": "2020-11-18",
        "certification_date": "2020-11-18",
        "status": "A",
        "authorized_official_last_name": "PETERSEN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "309-689-5880"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "0046243",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "743055934002",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Royal Oaks Care Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Royal Oaks Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Regional Family Health Center
• Regional Health Partners, LLC
• Mallory Lynn Reiber, ATC, PTA
• Stephen L Rider, DDS
• Karlynn Roecker, PHARMACIST
• Royal Hco, LLC
• Stephanie Rusk
• Lisa R Salisbury, M.S. CCC-SLP
• Scott Salisbury, PT, DPT, ATC, CSCS
• Malissa Sanders

• Skilled Nursing Facility in Kewanee, IL
• Providers in Kewanee, IL by specialty
• Skilled Nursing Facility in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.