Organization · Type 2 NPI
Petersen Health Network, LLC
Intellectual Disabilities Intermediate Care Facility · Rosiclare, IL
NPI number
1659405850
Active
Practice location
201 Spring Street
Rosiclare, IL 62982
Mailing address
830 W Trailcreek Dr
Peoria, IL 61614-1862
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nursing Facility/Intermediate Care Facility | 313M00000X | None listed |
| Intellectual Disabilities Intermediate Care Facility Primary | 315P00000X | None listed |
Intellectual Disabilities Intermediate Care Facility: An intermediate care facility providing services for individuals with intellectual disabilities.
About NPI 1659405850
Petersen Health Network, LLC's National Provider Identifier is 1659405850, issued on Mar 16, 2007. The primary taxonomy on file is Intellectual Disabilities Intermediate Care Facility (315P00000X), and the practice location is in Rosiclare, IL. The record was last updated on Jan 14, 2017.