Mt. Vernon Health Care Center

LBN: Petersen Management Company, Llc
Mt. Vernon Health Care Center is an health care organization with primary practice located at 5 Doctors Park Rd , Mount Vernon IL 62864-6224. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Nursing Facility/Intermediate Care Facility, which is considered as the primary health care specialty. Petersen Management Company, Llc can be contacted via phone (618) 242-1064, or through Petersen, Mark B. via phone (309) 691-8113.

Contact Information

Primary practice address
5 Doctors Park Rd Mount Vernon IL 62864-6224
Phone: (618) 242-1064
Fax: (618) 242-7559
Website:
Map and Directions
Authorized official contact:
Name: Petersen, Mark B.
Phone: (309) 691-8113

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Nursing Facility/Intermediate Care Facility 313M00000X 0039800 Illinois

Profile Details

NPI number 1780767897
LBN Legal business name Petersen Management Company, Llc
DBA Doing business as Mt. Vernon Health Care Center
Authorized official Petersen, Mark B.
Entity Organization
Organization subpart 1 Yes
Enumeration date Oct 23rd, 2006
Last updated May 30th, 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 1780767897 NPPES
Illinois MEDICAID 391516877001

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