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Penta Nascent Corporation
Intellectual Disabilities Intermediate Care Facility in Centralia, Illinois
NPI 1881814192

Penta Nascent Corporation is a Intellectual Disabilities Intermediate Care Facility based in Centralia, IL. Penta Nascent Corporation practices in Centralia, IL. The NPI Number for Penta Nascent Corporation is 1881814192 and holds a License No. 0038125 (Illinois).

The current practice location address for Penta Nascent Corporation is 920 W 4Th St, Centralia, IL and can be reached out via phone at 618-533-1199.

Location: 920 W 4Th St, Centralia, IL, 62801-9124
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1881814192
Provider Name
Penta Nascent Corporation
Credential
Provider Entity Type
Organization
Address
920 W 4Th St, Centralia, IL, 62801-9124
Phone Number
618-533-1199
Fax Number
Provider Enumeration Date
04/27/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
14G093 05 IL
institution
Provider Business Practice Location Address Details
Address
920 W 4Th St
City
Centralia
State
Illinois
Zip
62801-5718
Phone Number
618-533-1199
Fax Number
person
Provider Business Mailing Address Details
Address
920 W 4Th St
City
Centralia
State
Illinois
Zip
62801-5718
Phone Number
618-533-1199
Fax Number
person
Provider's Taxonomy Details 1
Type
Nursing & Custodial Care Facilities
Classification
Intermediate Care Facility, Mentally Retarded
Speciality
-
Taxonomy
315P00000X
License No.
0038125 (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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