Peterson Health Care, Inc.
Organization Active NPI Skilled Nursing Facility · Osage City, KS
NPI 1346358868 · NPPES record last updated Jan 27, 2012
Key facts
- NPI
- 1346358868
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- N070004 (KS)
- Legal business name
- PETERSON HEALTH CARE, INC.
- Practice address
- 630 Holliday St
Osage City, KS 66523-1138 - Phone
- (785) 528-4420
- Fax
- (785) 528-3501
- NPI assigned
- Aug 25, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- CRYSTAL CARE CENTERS, INC
Authorized official
- Name
- Ms. Crystal W Peterson
- Title
- Administrator
- Phone
- (785) 528-4420
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | N070004 | KS | Yes |
Addresses
Primary practice location
630 Holliday St
Osage City, KS 66523-1138
Mailing address
630 Holliday St
Osage City, KS 66523-1138
Phone (785) 528-4420
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100109480A | Medicaid | KS | |
| 1175 | Other | KS | BLUE CROSS BLUE SHIELD |
Other names
- Peterson Nursing Home
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All providers in Osage City, KS · Skilled Nursing Facility in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 27, 2012. 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.