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Petersen Health Quality, Llc
Intellectual Disabilities Intermediate Care Facility in Louisville, Illinois
NPI 1598721383

Petersen Health Quality, Llc is a Intellectual Disabilities Intermediate Care Facility based in Peoria, IL. Petersen Health Quality, Llc practices in Louisville, IL. The NPI Number for Petersen Health Quality, Llc is 1598721383 and holds a License No. 0046078 (Illinois).

The current practice location address for Petersen Health Quality, Llc is 52 Old Rte 45, Louisville, IL and can be reached out via phone at 618-686-4542 and via fax at 618-686-2179.

Location: 52 Old Rte 45, Louisville, IL, 61614-1862
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1598721383
Provider Name
Petersen Health Quality, Llc
Credential
Provider Entity Type
Organization
Address
52 Old Rte 45, Louisville, IL, 61614-1862
Phone Number
618-686-4542
Fax Number
618-686-2179
Provider Enumeration Date
04/21/2006
Last Update Date
03/12/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
37-1068286008 05 IL
institution
Provider Business Practice Location Address Details
Address
52 Old Rte 45
City
Louisville
State
Illinois
Zip
62858-0116
Phone Number
618-686-4542
Fax Number
618-686-2179
person
Provider Business Mailing Address Details
Address
52 Old Rte 45
City
Louisville
State
Illinois
Zip
62858-0116
Phone Number
618-686-4542
Fax Number
618-686-2179
person
Provider's Taxonomy Details 1
Type
Nursing & Custodial Care Facilities
Classification
Intermediate Care Facility, Mentally Retarded
Speciality
-
Taxonomy
315P00000X
License No.
0046078 (Illinois)
Definition
(1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals.
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