PETERSEN HEALTH SYSTEMS, INC. (NPI# 1700169877) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700169877 |
| Entity Type | Organization |
| Organization Name | PETERSEN HEALTH SYSTEMS, INC. |
| Other Organization Name | COURTYARD ESTATES OF PEORIA |
| Practice Address |
117 N Western Ave Peoria IL 61604-5629 |
| Mailing Address |
830 W Trailcreek Dr Peoria IL 61614-1862 |
| Practice Telephone | 3096742400 |
| Mailing Telephone | 3096918113 |
| Mailing Fax Number | 3096918622 |
| Enumeration Date | 2011-09-24 |
| Last Update Date | 2011-09-24 |
| Authorized Official Name | MARK B PETERSEN (PRESIDENT) |
| Authorized Official Telephone | 3096918113 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Courtyard Estates of Peoria | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982001970 | Petersen Health Systems, Inc. | Assisted Living Facility | 1000 Courtyard Est, Galva, IL 61434-4501 | 2014-11-19 |
| 1215061346 | Petersen Health Systems, Inc. | Assisted Living Facility | 141 Junior Ave, Kewanee, IL 61443-2507 | 2007-03-14 |
| 1841460029 | Petersen Health Systems, Inc. | Assisted Living Facility | 1200 W Broadway, Monmouth, IL 61462-1679 | 2008-03-04 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Iowa Business Entities | PETERSEN HEALTH SYSTEMS, INC. | 830 West Trailcreek Dr, Peoria, IL 61614 |
| Street Address |
117 N WESTERN AVE |
| City | PEORIA |
| State | IL |
| Zip Code | 61604-5629 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275096380 | Peoria Slf, LLC | Assisted Living Facility | 117 N Western Ave, Peoria, IL 61604-5650 | 2019-04-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205357928 | Nydia I Rodriguez | Nurse's Aide | 3305 N Finnell Ave, Peoria, IL 61604 | 2017-07-03 |
| 1720327976 | Brin Diagnostics Inc. | Clinical Medical Laboratory | 3216 W Kenwood, West Peoria, IL 61604 | 2013-02-07 |
| 1225373715 | Ngocyen Thi Ngo | Pharmacist | 2515 N Knoxville Avenue, Peoria, IL 61604 | 2012-12-10 |
| 1194027003 | Schelly Chiropractic, Inc | Chiropractor | 1208 W Loucks, Peoria, IL 61604 | 2010-11-29 |
| 1770755852 | Dental Sealants & More | Dentist | 2126 N. University St., Peoria, IL 61604 | 2008-03-28 |
| 1821266123 | David L Krick | Dentist | 2022 N University, Peoria, IL 61604 | 2008-02-20 |
| 1568658409 | Advanced Physicians Health Care, S.c. | Chiropractor | 1200 West Loucks Ave, Peoria, IL 61604 | 2007-09-24 |
| 1902006000 | Noel Liu | Dentist | 3127 N. University St., Unit C, Peoria, IL 61604 | 2007-07-18 |
| 1568586386 | Susan B Bordenave-bishop | Dentist | 2116 N. Sheridan, Peoria, IL 61604 | 2007-03-19 |
| 1174689897 | Paul Anthony Amodeo | Dentist | 3100 N Dries Lane, Suite 301, Peoria, IL 61604 | 2006-12-28 |
| Find all providers in zip 61604 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235730508 | Gheorghe Patrutescu | Assisted Living Facility | 16134 N 72nd Ln, Peoria, AZ 85382-4937 | 2020-11-03 |
| 1770103954 | Jcl Healthcare Solutions LLC | Assisted Living Facility | 10161 W Lawrence Ln, Peoria, AZ 85345-7380 | 2020-04-17 |
| 1912536368 | Agua Fria Senior Living, LLC | Assisted Living Facility | 8880 N 107th Ave, Peoria, AZ 85345-2908 | 2020-04-07 |
| 1750915872 | View Point Fairmont Village LLC | Assisted Living Facility | 10401 N 79th Ave, Peoria, AZ 85345-0742 | 2020-02-27 |
| 1104392349 | Orchid Residential Inc. | Assisted Living Facility | 9580 W Orchid Ln, Peoria, AZ 85345-7719 | 2018-10-15 |
| 1013492412 | Pleasant Sunset Assisted Living LLC | Assisted Living Facility | 21393 N 94th Ave, Peoria, AZ 85382-8300 | 2018-10-02 |
| 1245723220 | Ilie Valean | Assisted Living Facility | 8331 W Willowbrook Dr, Peoria, AZ 85382-0894 | 2018-06-13 |
| 1023524626 | Intouch Assisted Living Home Enterprise, LLC | Assisted Living Facility | 7233 W Paradise Ln, Peoria, AZ 85382-4942 | 2017-12-18 |
| 1275052151 | Arrowhead Shore Senior Living, LLC | Assisted Living Facility | 16124 N 87th Dr, Peoria, AZ 85382-3771 | 2017-09-12 |
| 1427577238 | Serene Valley Care LLC | Assisted Living Facility | 29751 N 119th Lane, Peoria, AZ 85383 | 2017-09-12 |
| Find all providers in PEORIA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.