Petersen Health Network, LLC
Organization Active NPI Skilled Nursing Facility · Flora, IL
NPI 1275622003 · NPPES record last updated Mar 18, 2017
Key facts
- NPI
- 1275622003
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 0038760 (IL)
- Legal business name
- PETERSEN HEALTH NETWORK, LLC
- Practice address
- 701 Shadwell Ave
Flora, IL 62839-2310 - Phone
- (618) 662-8361
- Fax
- (618) 662-2811
- NPI assigned
- Oct 12, 2006
- Organization subpart
- No
Authorized official
- Name
- Mark B Petersen
- Title
- President
- Phone
- (309) 691-8113
Corporate family (same tax ID) 11
National Provider Directory
- Tax ID family
- Flora Gardens Care Center
Locations
701 Shadwell Ave
Flora, IL 62839
Phone (618) 662-8361
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 0038760 | IL | Yes |
Addresses
Primary practice location
701 Shadwell Ave
Flora, IL 62839-2310
Mailing address
830 W Trailcreek Dr
Peoria, IL 61614-1862
Phone (309) 691-8113
Other names
- Flora Gardens Care Center
Other providers in Flora, IL
- Sarah Osborn
- Bryce Pearce
- Jessica Perry
- Petersen Companies, LLC
- Petersen Health Care II, Inc
- Petersen Management Company, LLC
- Christina Pierson
- Ponciano Pormentira Jr.
- John Dale Powless
- Robert C Powless
All providers in Flora, IL · Skilled Nursing Facility in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 18, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.