Organization
PETERSEN HEALTH & WELLNESS, LLC
Active
Other names
Enfield Rehabilitation & Health Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
MARK B. PETERSEN (MANAGE)
(309) 691-8113
Entity
Organization
Contact information
Practice address
408 N. WILSON, BOX 285, ENFIELD, IL 62835
(618) 963-2331
(618) 963-2083
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
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20-3224201009
—
IL
Enumeration date
06/14/2006
Last updated
08/01/2016
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