Organization
CASEY HCO, LLC
Active
Parent organization
PETERSEN HEALTH CARE II, INC.
Other names
Casey Health Care Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
PETERSEN HEALTH CARE II, INC.
Authorized official
MARK B. PETERSEN (MANAGER)
(309) 689-5880
Entity
Organization
Contact information
Practice address
100 NE 15TH ST, CASEY, IL 62420-2152
(217) 932-5217
(217) 932-5408
Mailing address
830 W TRAILCREEK DR, PEORIA, IL 61614-1862
(309) 691-8113
(309) 691-8622
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
74-3055934007
—
IL
Enumeration date
04/21/2006
Last updated
09/15/2020
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