Organization
PENTA NASCENT CORPORATION
Active
Other names
LYNWOOD ESTATES
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGIA MILLER (CEO)
(618) 548-4561
Entity
Organization
Contact information
Practice address
301 RODDY RD, SALEM, IL 62881-3836
(618) 548-0353
Mailing address
PO BOX 1690, CENTRALIA, IL 62801-9124
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
0036004
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
14G242
—
IL
Enumeration date
04/20/2007
Last updated
08/22/2020
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us