Petersen Management Company, Llc

NPI 1093771800 - Nursing Facility/Intermediate Care Facility - 313M00000X

NPI Details
NPI 1093771800
Enumeration Date 04/21/2006
Last Updated 05/23/2013
Entity Type Healthcare Provider
Active Over 10 years ago
Authorized Information
Name MARK B. MARK
Position PRESIDENT
Phone (217) 932-5217
Fax (217) 932-5408
Practice Location
100 NE 15TH ST
CASEY IL, 62420-2152, US
Phone (217) 932-5217
Fax (217) 932-5408
Business Location
830 W TRAILCREEK DR
PEORIA IL, 61614-1862, US
Phone (309) 691-8113
Fax (309) 691-8622
Toxanomy
Taxonomy Code 313M00000X
License State Illinois
License Number 0046714
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According to our database, Petersen Management Company, Llc NPI is 1093771800, taxonomy code is 313M00000X and license number is 0046714, license state is located at Illinois. Petersen Management Company, Llc physically located at 100 Ne 15th St, Casey IL, 62420-2152. NPI Number 1033115704 has the healthcare provider type.

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1093771800 NPI number is provided on an as is basis without warranty of any kind. 1093771800 is maintained by the National Plan & Provider Enumeration System. The contents of Petersen Management Company, Llc are for informational purposes only.