Petersen Companies, LLC
Organization Active NPI Skilled Nursing Facility · Charleston, IL
NPI 1346491503 · NPPES record last updated Oct 7, 2008
Key facts
- NPI
- 1346491503
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 0048546 (IL)
- Legal business name
- PETERSEN COMPANIES, LLC
- Practice address
- 716 18TH St
Charleston, IL 61920-2382 - Phone
- (217) 345-7054
- NPI assigned
- Oct 7, 2008
- Organization subpart
- No
Authorized official
- Name
- Mark Petersen
- Title
- Manager
- Phone
- (309) 691-8113
Corporate family (same tax ID) 11
National Provider Directory
- Tax ID family
- Flora Gardens Care Center
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 0048546 | IL | Yes |
Addresses
Primary practice location
716 18TH St
Charleston, IL 61920-2382
Mailing address
830 W Trailcreek Dr
Peoria, IL 61614-1862
Phone (309) 691-8113
Other names
- Charleston Rehabilitation & Health Care Center
Other providers in Charleston, IL
- Amy Overmyer
- Dennis Pearson
- Jacob Tage Pearson
- Brett Penning
- Erica Davis Perrino
- Jayme Petty
- Brittany Nicole Phebus
- Ellen M Pierce
- Macy Irene Piercefield
- James D Pitts
All providers in Charleston, 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 Oct 7, 2008. 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.