Organization
PETERSEN HEALTH CARE, INC
Active
Other names
Kewanee Care Home
Organization subpart
No
Provider details
NPI number
Authorized official
MARK PETERSEN (PRESIDENT)
(309) 691-8113
Entity
Organization
Contact information
Practice address
144 JOUNIOR AVE., KEWANEE, IL 61443
(618) 833-7093
Mailing address
830 W TRAILCREEK DR, PEORIA, IL 61614-1862
(309) 691-8113
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
0026518
IL
Other
Enumeration date
10/07/2008
Last updated
10/07/2008
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