Twin Hco, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

0041442 Issued in IL

Legal business name

TWIN HCO, LLC

Doing business as

Twin Lakes Rehabilitation & Health Care

Practice address

310 S Eads Ave
Paris, IL 61944-1938

Phone

(217) 465-5395

Fax

(217) 463-7905

NPI assigned

Sep 25, 2006

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

Manager

Phone

(309) 689-5880

Specialties & licenses 1

Addresses

Other names 1

• Twin Lakes Rehabilitation & Health Care Doing business as

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600041600000",
    "number": "1992805147",
    "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": "310 S EADS AVE",
            "city": "PARIS",
            "state": "IL",
            "postal_code": "619441938",
            "telephone_number": "217-465-5395",
            "fax_number": "217-463-7905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TWIN HCO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-25",
        "last_updated": "2020-09-14",
        "certification_date": "2020-09-14",
        "status": "A",
        "authorized_official_last_name": "PETERSEN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "309-689-5880"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "0041442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Twin Lakes Rehabilitation & Health Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Twin Lakes Rehabilitation & Health Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mika Jo Thomas, RDN
• Nicolas Thomas, APRN
• Kristen Mechele Trogdon, CCC-SLP
• Brianne Turner, RD
• Twin Hco, LLC
• Twin Lakes Extended Care LLC
• Union Associated Physicians Clinic, LLC
• Samantha Alexis Volstorf, FNP
• Jody Wagoner
• Wal-Mart Stores, Inc

• Skilled Nursing Facility in Paris, IL
• Providers in Paris, 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 Sep 14, 2020; 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.