Organization
PETERSEN COMPANIES, LLC
Active
Other names
Flora Gardens Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
MARK PETERSEN (MANAGER)
(309) 691-8113
Entity
Organization
Contact information
Practice address
701 SHADWELL AVE, FLORA, IL 62839-2310
(618) 662-8361
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
0048538
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20103299015
—
IL
Enumeration date
10/21/2008
Last updated
10/21/2008
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