NPI 1598917775

Petersen Health Operations, LLC

Organisation Skilled Nursing Facility Benton, IL

Practice location

Address: 1409 N Main St, Benton, IL 62812-1918
Phone: (618) 435-2712
Mailing address: 830 W Trailcreek Dr, Peoria, IL 61614-1862

Authorised official

Name: Mark Petersen
Title: Manager
Phone: (309) 691-8113

Registered specialties

Skilled Nursing Facility Primary

Nursing & Custodial Care Facilities Taxonomy 314000000X Licence 0047407 (IL)

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Registry record

NPI: 1598917775
Entity type: Organization
NPI issued: 21 Oct 2008
Record last updated: 21 Oct 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.