Tuscola Hco, LLC
Organization Active NPI Skilled Nursing Facility · Tuscola, IL
NPI 1609976869 · NPPES record last updated Sep 24, 2020
Key facts
- NPI
- 1609976869
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 0046805 (IL)
- Legal business name
- TUSCOLA HCO, LLC
- Practice address
- 1203 Egyptian TRL
Tuscola, IL 61953-2050 - Phone
- (217) 253-4791
- Fax
- (217) 253-3754
- NPI assigned
- Sep 25, 2006
- Organization subpart
- No
Authorized official
- Name
- Mark B. Petersen
- Title
- Manager
- Phone
- (309) 689-5880
National Provider Directory
Locations
408 Wilson St
Enfield, IL 62835
Phone (618) 963-2331
2116 W South 3rd St
Shelbyville, IL 62565
Phone (217) 774-2128
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 0046805 | IL | Yes |
Addresses
Primary practice location
1203 Egyptian TRL
Tuscola, IL 61953-2050
Mailing address
830 W Trailcreek Dr
Peoria, IL 61614-1862
Phone (309) 691-8113
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 474213665001 | Medicaid | IL |
Other providers in Tuscola, IL
- Bart M Tate
- Douglas Alan Teel
- Payton Turk
- Tuscola Comm Unit School Dist 301
- Tuscola Hco, LLC
- Tuscola Pain & Wellness Center SC
- Brooke Michaela Vonlanken
- WC- Tuscola Ops, LLC
- Debra Wells
- Kimberly B Whitaker
All providers in Tuscola, 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 Sep 24, 2020. 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.