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PETERSEN HEALTH OPERATIONS LLC NPI 1225071442


NPI Information

NPI: 1225071442
Provider Name: PETERSEN HEALTH OPERATIONS, LLC

Doing Business As: CISNE REHABILITATION & HEALTH CENTER

Classification: Nursing Facility/Intermediate Care Facility - 313M00000X
Entity Type: Organization

CLIA Number: 14D0870126

Address:
107 N WATKINS STREET
CISNE, IL
ZIP 62823
Phone: (618) 673-2177
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PETERSEN HEALTH OPERATIONS, LLC is a nursing facility intermediate care facility in Cisne, IL. The provider is an institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals. PETERSEN HEALTH OPERATIONS, LLC NPI is 1225071442. The provider is registered as an organization entity type.
The provider Is Doing Business As Cisne Rehabilitation & Health Center.

The provider's business location address is:

107 N WATKINS STREET
CISNE, IL
ZIP 62823
Phone: (618) 673-2177
Fax: (618) 673-2309

The provider's authorized official is Mark B Petersen .
The authorized official title is Manager and has the following contact phone number (309) 691-8113.

The CLIA number assigned to this NPI record is 14D0870126 - skilled nursing facility/nursing facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/14/2006 and was last updated on 1/19/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1313M00000XNursing Facility/Intermediate Care Facility0047423ILLINOISYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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