Palm Terrace Of Mattoon

LBN: Petersen Management Company, Llc
Palm Terrace Of Mattoon is an health care organization with primary practice located at 1000 Palm Ave , Mattoon IL 61938-6031. 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 (217) 234-7403, or through Petersen, Mark B. via phone (309) 691-8113.

Contact Information

Primary practice address
1000 Palm Ave Mattoon IL 61938-6031
Phone: (217) 234-7403
Fax: (217) 258-6642
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 0046037 Illinois

Profile Details

NPI number 1487610291
LBN Legal business name Petersen Management Company, Llc
DBA Doing business as Palm Terrace Of Mattoon
Authorized official Petersen, Mark B.
Entity Organization
Organization subpart 1 Yes
Enumeration date Apr 21st, 2006
Last updated May 23rd, 2013 - about 11 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 1487610291 NPPES
Illinois MEDICAID 74-3055934001

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