Organization
SHANGRI LA HCO, LLC
Active
Other names
Shangri la Rehab and Living Center
Organization subpart
No
Provider details
NPI number
Authorized official
MARK B. PETERSEN (MANAGER)
(309) 689-5880
Entity
Organization
Contact information
Practice address
930 NE DUNCAN RD, BLUE SPRINGS, MO 64014-2173
(816) 229-6677
(816) 229-8064
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
Enumeration date
06/10/2009
Last updated
09/10/2020
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