Havana Hco, Llc in Peoria - Skilled Nursing Facility
Havana Hco, Llc - NPI 1346206315
Havana Hco, Llc is a Skilled Nursing Facility in Peoria, Illinois. Havana Hco, Llc practices all healthcare services and medical treatments related to Skilled Nursing Facility. The NPI Number for Havana Hco, Llc is 1346206315. The last update date is 2020-09-28.
Havana Hco, Llc's current location address is 830 W Trailcreek Dr, Peoria, Illinois. You can contact this provider via phone number 3096918113 and fax number 3096918622. The mailing address for Havana Hco, Llc is 830 W Trailcreek Dr, Peoria, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Havana Hco, Llc |
|---|---|
| Address | 830 W Trailcreek Dr, Peoria, Illinois |
| Phone Number | 3096918113 |
| Fax Number | 3096918622 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | MANAGER |
|---|---|
| Authorized Official Name | Petersen B. Mark |
| Telephone Number | 3096895880 |
NPI Number Detail
| NPI Number | 1346206315 |
|---|---|
| Provider Enumeration Date | 2006-04-26 |
| Last Updated Date | 2020-09-28 |
Provider Mailing Address Detail
| Address | 830 W Trailcreek Dr |
|---|---|
| City | Peoria |
| State | Illinois (IL) |
| Post Code | 616141862 |
| Phone Number | 3096918113 |
| Fax Number | 3096918622 |
Provider's Primary Taxonomy Detail
| Speciality | Skilled Nursing Facility |
|---|---|
| Taxonomy | 314000000X |
| Licence No | 46086 |
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Definition: (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring serv |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 37-1068286007 | IL | -- |
Post Comment/ Review Below
What is the unique 10-digit identification code issued to Havana Hco, Llc by the Centers for Medicare & Medicaid Services?
The Havana Hco, Llc has been assigned the NPI (National Provider Identifier) 1346206315 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you kindly provide the complete physical address where Havana Hco, Llc's facilities are geographically located?
The facilities of Havana Hco, Llc are physically situated at the following location: 830 W Trailcreek Dr, Peoria, IL, 616141862.
What is the Havana Hco, Llc's area of specialization and corresponding taxonomy classification?
The Havana Hco, Llc's specialty field is Skilled Nursing Facility, and it falls under the taxonomy code 314000000X, which categorizes healthcare providers based on their specialties.
On what date did the Havana Hco, Llc receive the assignment of its 1346206315 from the Centers for Medicare & Medicaid Services?
The Havana Hco, Llc was issued its 1346206315 by the Centers for Medicare & Medicaid Services on 2006-04-26.
As of what date were the details related to Havana Hco, Llc most recently updated or revised?
The information pertaining to Havana Hco, Llc, including its address, specialty, and other relevant details, was last updated or revised on 2020-09-28.