Petersen Management Company Llc in Peoria - Skilled Nursing Facility
Petersen Management Company Llc - NPI 1720045164
Petersen Management Company Llc is a Skilled Nursing Facility in Peoria, Illinois. Petersen Management Company Llc practices all healthcare services and medical treatments related to Skilled Nursing Facility. The NPI Number for Petersen Management Company Llc is 1720045164. The last update date is 2019-02-14.
Petersen Management Company 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 Petersen Management Company Llc is 830 W Trailcreek Dr, Peoria, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Petersen Management Company Llc |
|---|---|
| Address | 830 W Trailcreek Dr, Peoria, Illinois |
| Phone Number | 3096918113 |
| Fax Number | 3096918622 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PRESIDENT |
|---|---|
| Authorized Official Name | Petersen B. Mark |
| Telephone Number | 3096918113 |
NPI Number Detail
| NPI Number | 1720045164 |
|---|---|
| Provider Enumeration Date | 2006-04-28 |
| Last Updated Date | 2019-02-14 |
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 | 46854 |
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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 |
|---|---|---|---|
| 74-3055934011 | IL | -- |
Post Comment/ Review Below
What is the unique 10-digit identification code assigned to Petersen Management Company Llc by the Centers for Medicare & Medicaid Services?
The Petersen Management Company Llc has been issued the NPI (National Provider Identifier) 1720045164, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you please provide the complete physical location address of Petersen Management Company Llc?
The Petersen Management Company Llc is physically situated at 830 W Trailcreek Dr, in the city of Peoria, state of IL, with the postal code 616141862.
What is the area of specialization for Petersen Management Company Llc, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Petersen Management Company Llc is Skilled Nursing Facility, and the corresponding taxonomy code that categorizes this area of expertise is 314000000X.
When did the Petersen Management Company Llc receive its 1720045164?
The Petersen Management Company Llc was issued its 1720045164 on 2006-04-28, which is the date when the organization was assigned this unique identifier.
When was the information regarding Petersen Management Company Llc, such as address, specialty, and other details, most recently verified or confirmed to be accurate?
The information pertaining to Petersen Management Company Llc, including its address, specialty, and other relevant details, was most recently verified or confirmed to be accurate on 2019-02-14.