# PETERSON HEALTH CARE, INC.

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** CRYSTAL CARE CENTERS, INC
- **Other names:** Peterson Nursing Home
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1346358868
- **Legal business name:** CRYSTAL CARE CENTERS, INC
- **Authorized official:** MS. CRYSTAL W PETERSON (ADMINISTRATOR)
- **Authorized official phone:** (785) 528-4420

## Contact information

- **Practice address:** 630 HOLLIDAY ST, OSAGE CITY, KS 66523-1138
- **Practice address phone:** (785) 528-4420
- **Practice address fax:** (785) 528-3501
- **Mailing address:** 630 HOLLIDAY ST, OSAGE CITY, KS 66523-1138
- **Mailing address phone:** (785) 528-4420
- **Mailing address fax:** (785) 528-3501

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | N070004 | KS | Yes |

## Other

- **Enumeration date:** 08/25/2006
- **Last updated:** 01/27/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100109480A | — | KS |
| 01 | — | 1175 | BLUE CROSS BLUE SHIELD | KS |