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Petersen Health Care II, Inc

Organization Active NPI Skilled Nursing Facility · Swansea, IL

NPI 1447401690 · NPPES record last updated Feb 26, 2019

Key facts

NPI
1447401690
Entity type
Organization (NPI type 2)
Primary specialty
Skilled Nursing Facility 314000000X
License
0048611 (IL)
Legal business name
PETERSEN HEALTH CARE II, INC
Practice address
1405 N 2ND St
Swansea, IL 62226-4213
Phone
(618) 233-6625
NPI assigned
Oct 7, 2008
Organization subpart
No

Authorized official

Name
Mark Petersen
Title
President
Phone
(309) 691-8113

Corporate family (same tax ID) 8

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Petersen Health Care LL Inc (9 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 0048611 IL Yes

Addresses

Primary practice location

1405 N 2ND St
Swansea, IL 62226-4213

Mailing address

830 W Trailcreek Dr
Peoria, IL 61614-1862
Phone (309) 691-8113

Other names

  • Swansea Rehabilitation & Health Care Center Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 26, 2019.

{
    "created_epoch": "1223337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551139200000",
    "number": "1447401690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 W TRAILCREEK DR",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616141862",
            "telephone_number": "309-691-8113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 N 2ND ST",
            "city": "SWANSEA",
            "state": "IL",
            "postal_code": "622264213",
            "telephone_number": "618-233-6625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETERSEN HEALTH CARE II, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-07",
        "last_updated": "2019-02-26",
        "status": "A",
        "authorized_official_last_name": "PETERSEN",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "309-691-8113"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "0048611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Swansea Rehabilitation & Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Swansea, IL

All providers in Swansea, IL · Skilled Nursing Facility in Illinois

Sources for this page

Verify at the official NPI Registry.