Bryan Manor

LBN: Penta Group Inc.
Bryan Manor is an health care organization with primary practice located at 2150 E Mccord St , Centralia IL 62801-6730. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded, which is considered as the primary health care specialty. Penta Group Inc. can be contacted via phone (618) 918-3770, or through Miller, Georgia via phone (618) 918-3770.

Contact Information

Primary practice address
2150 E Mccord St Centralia IL 62801-6730
Phone: (618) 918-3770
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Miller, Georgia
Phone: (618) 918-3770

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded 315P00000X 0033373 Illinois

Profile Details

NPI number 1932246071
LBN Legal business name Penta Group Inc.
DBA Doing business as Bryan Manor
Authorized official Miller, Georgia
Entity Organization
Organization subpart 1 No
Enumeration date Jan 30th, 2007
Last updated Oct 18th, 2010 - about 14 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932246071 NPPES
Illinois MEDICAID 14G037

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