Peoria NH LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

PEORIA NH LLC

Practice address

1500 W Northmoor Rd
Peoria, IL 61614-3435

Phone

(309) 691-2200

Fax

(309) 691-1548

NPI assigned

Dec 1, 2016

Organization subpart

No

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

Authorized official

Name

James Mason

Title

President

Phone

(813) 347-7425

Specialties & licenses 1

Addresses

Other names 1

• River Crossing of Peoria Doing business as

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Fal - Mountain Crest Inc.

  • Skilled Nursing Facility
  • Cincinnati, OH
  • NPI 1487839841

  Member Of

  NPD member

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

{
    "created_epoch": "1480550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624579200000",
    "number": "1265975700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 W NORTHMOOR RD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616143435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 W NORTHMOOR RD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616143435",
            "telephone_number": "309-691-2200",
            "fax_number": "309-691-1548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEORIA NH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-01",
        "last_updated": "2021-06-25",
        "certification_date": "2021-06-25",
        "status": "A",
        "authorized_official_last_name": "MASON",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "813-347-7425"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "River Crossing of Peoria",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Peoria, IL
• Providers in Peoria, 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 Jun 25, 2021; 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.