Organization
ROSICLARE HCO, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK B. PETERSEN (MANAGER)
(309) 691-8113
Entity
Organization
Contact information
Practice address
55 FERRELL RD, ROSICLARE, IL 62982-1006
(618) 285-3655
Mailing address
830 W TRAILCREEK DR, PEORIA, IL 61614-1862
(309) 689-5880
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
02/17/2020
Last updated
02/17/2020
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