Countryview Terrace

LBN: Petersen Health Quality, Llc
Countryview Terrace is an health care organization with primary practice located at 52 Old Rte 45 , Louisville IL 62858-0116. 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. Petersen Health Quality, Llc can be contacted via phone (618) 686-4542, or through Petersen, Mark B. via phone (309) 691-8113.

Contact Information

Primary practice address
52 Old Rte 45 Louisville IL 62858-0116
Phone: (618) 686-4542
Fax: (618) 686-2179
Website:
Map and Directions
Authorized official contact:
Name: Petersen, Mark B.
Phone: (309) 691-8113

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded 315P00000X 0046078 Illinois

Profile Details

NPI number 1598721383
LBN Legal business name Petersen Health Quality, Llc
DBA Doing business as Countryview Terrace
Authorized official Petersen, Mark B.
Entity Organization
Organization subpart 1 Yes
Enumeration date Apr 21st, 2006
Last updated Feb 14th, 2024 - about 9 months 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 1598721383 NPPES
Illinois MEDICAID 37-1068286008

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