Organization
PETERSEN HEALTH CARE INC
Active
Other names
Havana Health Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
MARK PETERSEN (PRESIDENT)
(309) 691-8113
Entity
Organization
Contact information
Practice address
609 N HARPHAM ST, HAVANA, IL 62644-1249
(309) 543-6121
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
0046086
IL
Other
Enumeration date
10/07/2008
Last updated
10/07/2008
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