NPI 1932246071

Penta Group INC.

Organisation Intellectual Disabilities Intermediate Care Facility Centralia, IL

Practice location

Address: 2150 E McCord St, Centralia, IL 62801-6730
Phone: (618) 918-3770
Mailing address: PO Box 687, Centralia, IL 62801-9111

Authorised official

Name: Georgia Miller
Title: Administrator
Phone: (618) 918-3770

Registered specialties

Intellectual Disabilities Intermediate Care Facility Primary

Nursing & Custodial Care Facilities Taxonomy 315P00000X Licence 0033373 (IL)

Other Intermediate Care Facility, Intellectual Disabilities providers in Illinois →

Registry record

NPI: 1932246071
Entity type: Organization
NPI issued: 30 Jan 2007
Record last updated: 18 Oct 2010

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.