East Peoria Nh LLC
NPI #1114460839 in East Peoria, Illinois
Provider Information
- NPI Number
- 1114460839
- Entity Type
- Organization
- Organization Name
- East Peoria Nh LLC
- Primary Specialty
- Nursing Facility/Intermediate Care Facility
- Enumeration Date
- Nov 29, 2016
- Last Updated
- Jun 25, 2021
Practice Location
- Address
- 900 CENTENNIAL DR
- City
- East Peoria
- State
- Illinois
- ZIP Code
- 61611-4928
- Phone
- (309) 699-5400
Authorized Official
- Name
- JAMES MASON
- Title
- PRESIDENT
- Phone
- (813) 347-7425
Specialties & Taxonomy Codes
| Specialty |
|---|
| Nursing Facility/Intermediate Care Facility |
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