Peoria SLF LP

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

PEORIA SLF LP

Practice address

518 West Romeo B. Garrett Avenue
Peoria, IL 61605

Phone

(309) 673-3115

Fax

(309) 673-3117

NPI assigned

Aug 28, 2016

Organization subpart

No

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

Authorized official

Name

Joellen Bleavins

Title

President of Gardant Management Sol

Phone

(815) 935-1992

Specialties & licenses 1

Addresses

Other names 1

• GateWay at River City Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1472342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472342400000",
    "number": "1891241022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "518 WEST ROMEO B. GARRETT AVENUE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "61605",
            "telephone_number": "309-673-3115",
            "fax_number": "309-673-3117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "518 WEST ROMEO B. GARRETT AVENUE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "61605",
            "telephone_number": "309-673-3115",
            "fax_number": "309-673-3117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEORIA SLF LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-28",
        "last_updated": "2016-08-28",
        "status": "A",
        "authorized_official_last_name": "BLEAVINS",
        "authorized_official_first_name": "JOELLEN",
        "authorized_official_title_or_position": "PRESIDENT OF GARDANT MANAGEMENT SOL",
        "authorized_official_telephone_number": "815-935-1992"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GateWay at River City",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Peoria Podiatry Group PC
• Peoria Psychological Associates, P.C.
• Peoria Pulmonary Associates, LTD.
• Peoria School Dist 150
• Peoria School District 150
• Peoria SLF, LLC
• Peoria Specialty, Inc.
• Peoria Spine and Sport LTD.
• Peoria Surgical Group, LTD.
• Peoria Tazewell Pathology Group, S.C.

• Assisted Living Facility in Peoria, IL
• Providers in Peoria, IL by specialty
• Assisted Living Facility in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.