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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
100109480AMedicaidKS
1175OtherKSBLUE CROSS BLUE SHIELD

Other names

  • Peterson Nursing Home Other name

Other providers in Osage City, KS

All providers in Osage City, KS · Skilled Nursing Facility in Kansas

Sources for this page

Verify at the official NPI Registry.