Organization · Type 2 NPI

Petersen Management Company, LLC

Skilled Nursing Facility · Mount Vernon, IL

NPI number 1932132115 Active

Practice location

1700 White St
Mount Vernon, IL 62864-4349

Call (618) 242-4075 Map

Fax (618) 242-4092

Mailing address

830 W Trailcreek Dr
Peoria, IL 61614-1862

Specialties and licenses

Taxonomy	Code	License
Skilled Nursing Facility Primary	314000000X	None listed

Skilled Nursing Facility: (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 services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to r…

9 other providers at this address

Other skilled nursing facility providers in Mount Vernon

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NPI record

NPI: 1932132115
Entity type: Organization (Type 2)
Issued: Jul 9, 2006
Last updated: May 23, 2013
Status: Active
Subpart: Yes of Petersen Health Care Ii, Inc

Other names

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White Oak Rehabilitation & Health Care Center · doing business as

Authorized official

Mark B. Petersen
President
(309) 691-8113

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1932132115

Petersen Management Company, LLC's National Provider Identifier is 1932132115, issued on Jul 9, 2006. The primary taxonomy on file is Skilled Nursing Facility (314000000X), and the practice location is in Mount Vernon, IL. The record was last updated on May 23, 2013.