<Unavail>

LBN: Petersen Management Company, Llc
<Unavail> is an health care organization with primary practice located at 1700 White St , Mount Vernon IL 62864-4349. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Skilled Nursing Facility, which is considered as the primary health care specialty. Petersen Management Company, Llc can be contacted via phone (618) 242-4075, or through Petersen, Mark B. via phone (309) 691-8113.

Contact Information

Primary practice address
1700 White St Mount Vernon IL 62864-4349
Phone: (618) 242-4075
Fax: (618) 242-4092
Website:
Map and Directions
Authorized official contact:
Name: Petersen, Mark B.
Phone: (309) 691-8113

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Skilled Nursing Facility 314000000X

Profile Details

NPI number 1932132115
LBN Legal business name Petersen Management Company, Llc
DBA Doing business as <Unavail>
Authorized official Petersen, Mark B.
Entity Organization
Organization subpart 1 Yes
Enumeration date Jul 9th, 2006
Last updated May 23rd, 2013 - about 13 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1932132115 NPPES
Illinois MEDICAID 743055934014

Popular Providers