Organization
ROYAL HCO, LLC
Active
Other names
Royal Oaks Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
MARK B. PETERSEN (MANAGER)
(309) 689-5880
Entity
Organization
Contact information
Practice address
605 E CHURCH ST, KEWANEE, IL 61443-3503
(309) 852-3389
(309) 853-1838
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
0046243
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
743055934002
—
IL
Enumeration date
04/21/2006
Last updated
11/18/2020
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