Organization
PETERSEN HEALTH PROPERTIES, LLC
Active
Other names
Jonesboro Rehabilitation & Health Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
MARK B. PETERSEN (MANAGER)
(309) 691-8113
Entity
Organization
Contact information
Practice address
995 STATE ROUTE 127 S, BOX B, JONESBORO, IL 62952-2423
(618) 833-7093
(618) 833-4825
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
0043562
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20-3224201016
—
IL
Enumeration date
06/02/2006
Last updated
12/31/2019
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