Eastview Hco, LLC

Organization Active NPI Skilled Nursing Facility · Sullivan, IL

NPI 1700843448 · NPPES record last updated Sep 28, 2020

Key facts

NPI
1700843448
Entity type
Organization (NPI type 2)
Primary specialty
Skilled Nursing Facility 314000000X
License
0046060 (IL)
Legal business name
EASTVIEW HCO, LLC
Practice address
100 Eastview PL
Sullivan, IL 61951-1674
Phone
(217) 728-7367
Fax
(217) 728-2112
NPI assigned
Apr 27, 2006
Organization subpart
Yes
Parent organization (as reported)
PETERSEN HEALTH CARE, INC

Authorized official

Name
Mark B. Petersen
Title
Manager
Phone
(309) 689-5880

National Provider Directory

Part of
Petersen Health Care Inc

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 0046060 IL Yes

Addresses

Primary practice location

100 Eastview PL
Sullivan, IL 61951-1674

Mailing address

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

Other identifiers

IdentifierTypeStateIssuer
37-1068286009MedicaidIL

Other names

  • Eastview Terrace Doing business as

Other providers in Sullivan, IL

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

Sources for this page

Verify at the official NPI Registry.