Organization
PETERSEN HEALTH CARE, INC
Active
Other names
Bement Health Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK B PETERSEN (PRESIDENT)
(309) 691-8113
Entity
Organization
Contact information
Practice address
601 N MORGAN ST, BEMENT, IL 61813-1046
(217) 678-2191
Mailing address
830 W TRAILCREEK DR, PEORIA, IL 61614-1862
(309) 691-8113
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0046052
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
203224201040
—
IL
Enumeration date
10/07/2008
Last updated
10/07/2008
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