Organization
LTC OF ILLINOIS - FIRESIDE, INC.
Active
Other names
Fireside House of Centralia
Organization subpart
No
Provider details
NPI number
Authorized official
DOUGLAS K MITTLEIDER (PRESIDENT)
(770) 619-0866
Entity
Organization
Contact information
Practice address
1030 MARTIN LUTHER KING DR, CENTRALIA, IL 62801-3002
(618) 532-1833
(618) 532-1308
Mailing address
1030 MARTIN LUTHER KING DR, CENTRALIA, IL 62801-3002
(618) 532-1833
(618) 532-1308
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0045690
IL
Other
Enumeration date
07/10/2006
Last updated
04/20/2008
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