Petersen Management Company LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

0046854 Issued in IL

Legal business name

PETERSEN MANAGEMENT COMPANY LLC

Doing business as

Toulon Rehabilitation & Health Care Center

Practice address

Highway 17 East
Toulon, IL 61483

Phone

(309) 286-2631

Fax

(309) 286-4851

NPI assigned

Apr 28, 2006

Last updated

Feb 14, 2019By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mark B. Petersen

Title

President

Phone

(309) 691-8113

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Toulon Rehabilitation & Health Care Center Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550102400000",
    "number": "1720045164",
    "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",
            "fax_number": "309-691-8622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HIGHWAY 17 EAST",
            "city": "TOULON",
            "state": "IL",
            "postal_code": "61483",
            "telephone_number": "309-286-2631",
            "fax_number": "309-286-4851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETERSEN MANAGEMENT COMPANY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-28",
        "last_updated": "2019-02-14",
        "status": "A",
        "authorized_official_last_name": "PETERSEN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "B.",
        "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": "0046854",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "74-3055934011",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Toulon Rehabilitation & Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Toulon Rehabilitation & Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Brooke Down, BSW, MSW
• Local Health Inc (Abingdon Telepharmacy)
• North Central Behavioral Health Systems, Inc.
• Mallery Pearson
• Petersen Health Care II, Inc (Toulon Rehabilitation & Health Care Center)
• Amy Marie Snyder, D.C.
• Stark County Ambulance Service Inc
• Stark County Community Unit School District 100
• Toulon Fire Protection District

• Skilled Nursing Facility in Toulon, IL
• Providers in Toulon, IL by specialty
• Skilled Nursing Facility in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.