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Petersen Health Care Ll, Inc.
Nursing Facility/Intermediate Care Facility in Mount Vernon, Illinois
NPI 1659471993

Petersen Health Care Ll, Inc. is a Nursing Facility/Intermediate Care Facility based in Peoria, IL. Petersen Health Care Ll, Inc. practices in Mount Vernon, IL. The NPI Number for Petersen Health Care Ll, Inc. is 1659471993 and holds a License No. 0047902 (Illinois).

The current practice location address for Petersen Health Care Ll, Inc. is 1717 Jefferson Ave, Mount Vernon, IL and can be reached out via phone at 999-999-9999.

Location: 1717 Jefferson Ave, Mount Vernon, IL, 61614-1862
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1659471993
Provider Name
Petersen Health Care Ll, Inc.
Credential
Provider Entity Type
Organization
Address
1717 Jefferson Ave, Mount Vernon, IL, 61614-1862
Phone Number
999-999-9999
Fax Number
Provider Enumeration Date
09/25/2006
Last Update Date
03/08/2024
institution
Provider Business Practice Location Address Details
Address
1717 Jefferson Ave
City
Mount Vernon
State
Illinois
Zip
62864-4330
Phone Number
999-999-9999
Fax Number
person
Provider Business Mailing Address Details
Address
1717 Jefferson Ave
City
Mount Vernon
State
Illinois
Zip
62864-4330
Phone Number
999-999-9999
Fax Number
person
Provider's Taxonomy Details 1
Type
Nursing & Custodial Care Facilities
Classification
Nursing Facility/Intermediate Care Facility
Speciality
-
Taxonomy
313M00000X
License No.
0047902 (Illinois)
Definition
An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals.
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