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Penta Group Inc.
Intellectual Disabilities Intermediate Care Facility in Centralia, Illinois
NPI 1932246071

Penta Group Inc. is a Intellectual Disabilities Intermediate Care Facility based in Centralia, IL. Penta Group Inc. practices in Centralia, IL. The NPI Number for Penta Group Inc. is 1932246071 and holds a License No. 0033373 (Illinois).

The current practice location address for Penta Group Inc. is 2150 E Mccord St, Centralia, IL and can be reached out via phone at 618-918-3770.

Location: 2150 E Mccord St, Centralia, IL, 62801-9111
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1932246071
Provider Name
Penta Group Inc.
Credential
Provider Entity Type
Organization
Address
2150 E Mccord St, Centralia, IL, 62801-9111
Phone Number
618-918-3770
Fax Number
Provider Enumeration Date
01/30/2007
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
14G037 05 IL
institution
Provider Business Practice Location Address Details
Address
2150 E Mccord St
City
Centralia
State
Illinois
Zip
62801-6730
Phone Number
618-918-3770
Fax Number
person
Provider Business Mailing Address Details
Address
2150 E Mccord St
City
Centralia
State
Illinois
Zip
62801-6730
Phone Number
618-918-3770
Fax Number
person
Provider's Taxonomy Details 1
Type
Nursing & Custodial Care Facilities
Classification
Intermediate Care Facility, Mentally Retarded
Speciality
-
Taxonomy
315P00000X
License No.
0033373 (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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