PETERSEN HEALTH & WELLNESS, LLC (NPI# 1346283587) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346283587 |
| Entity Type | Organization |
| Organization Name | PETERSEN HEALTH & WELLNESS, LLC |
| Other Organization Name | ENFIELD REHABILITATION & HEALTH CARE CENTER |
| Practice Address |
408 N. Wilson Box 285 Enfield IL 62835 |
| Mailing Address |
830 W Trailcreek Dr Peoria IL 61614-1862 |
| Practice Telephone | 6189632331 |
| Practice Fax Number | 6189632083 |
| Mailing Telephone | 3096918113 |
| Mailing Fax Number | 3096918622 |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2016-08-01 |
| Authorized Official Name | MARK B. PETERSEN (MANAGE) |
| Authorized Official Telephone | 3096918113 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 20-3224201009 | 05 |
| Other Name | Type Code |
|---|---|
| Enfield Rehabilitation & Health Care Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578646691 | Petersen Health & Wellness, LLC | Skilled Nursing Facility | 418 S Memorial Park Rd, Newman, IL 61942-8062 | 2006-10-23 |
| 1528006004 | Petersen Health & Wellness, LLC | Skilled Nursing Facility | 430 Martin Rd, Rock Falls, IL 61071-1954 | 2006-06-04 |
| 1063459329 | Petersen Health & Wellness, LLC | Nursing Facility/Intermediate Care Facility | 136 S Dipper Ln, Decatur, IL 62522-1841 | 2006-06-02 |
| Street Address |
408 N. WILSON BOX 285 |
| City | ENFIELD |
| State | IL |
| Zip Code | 62835 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427559616 | Brooklyn Naas | Speech-Language Pathologist | 215 N. First Street, Enfield, IL 62835 | 2018-02-23 |
| 1417389917 | Susan Chabot | Physical Therapy Assistant | 1851 County Road 100 E, Enfield, IL 62835-2002 | 2013-08-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669070827 | Hometown Health, LLC | Clinic/Center | 54 Hazard Ave # 161, Enfield, CT 06082-3845 | 2020-10-10 |
| 1407453319 | Khyan Waddell | Physician Assistant | 127 Sneed Rd, Enfield, NC 27823-9589 | 2020-10-04 |
| 1528672722 | Hartford Orthopedic Surgeons, PC | Podiatrist | 9 Cranbrook Blvd Fl 2, Enfield, CT 06082-3889 | 2020-09-04 |
| 1003428897 | Francesca Nicole Porter | Counselor | 39 Burnham St, Enfield, CT 06082-6144 | 2020-08-21 |
| 1386253102 | Damien C Grimsley | Massage Therapist | 123 Windsor St, Enfield, CT 06082-2850 | 2020-07-28 |
| 1487271680 | Zachary Leone | Physician Assistant | 74 Raffia Rd, Enfield, CT 06082-5161 | 2020-07-03 |
| 1952925083 | Amanda Govine | Occupational Therapist | 50 Brett Ln, Enfield, CT 06082-4102 | 2020-06-04 |
| 1669007076 | Pain Management Partners LLC | Anesthesiology | 7 Elm St Ste 202, Enfield, CT 06082-3670 | 2020-03-05 |
| 1487295168 | Kestin Bunnell | Specialist/Technologist | 327 Bog Rd, Enfield, NH 03748-4103 | 2019-10-03 |
| 1093366924 | Gaetano Balsamo | Technician | 188 Post Office Rd Unit 1, Enfield, CT 06082-5686 | 2019-09-23 |
| Find all providers in ENFIELD | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821024274 | Eagle Peak Ltc Group, LLC | Skilled Nursing Facility | 208 Cary St, Enfield, NC 27823-1204 | 2006-06-25 |
| 1043209570 | Parkway Pavilion Healthcare | Skilled Nursing Facility | 1157 Enfield St, Enfield, CT 06082-4329 | 2005-10-18 |
| 1205839065 | Health Care Alliance, Inc D/b/a/ Blair Manor | Skilled Nursing Facility | 612 Hazard Ave, Enfield, CT 06082-4225 | 2005-05-24 |
| 1821541194 | Wv-parkway Pavilion LLC | Skilled Nursing Facility | 1157 Enfield St, Enfield, CT 06082-4367 | 2016-08-03 |
| 1407274103 | Ch-parkway Pavillion LLC | Skilled Nursing Facility | 1157 Enfield St, Enfield, CT 06082-4367 | 2014-04-01 |
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|---|---|---|---|---|
| 1902413537 | Citadel of Glenview LLC | Skilled Nursing Facility | 1700 E Lake Ave, Glenview, IL 60025-2003 | 2020-09-28 |
| 1598379075 | Patient Builders Marketing | Skilled Nursing Facility | 800 W Army Trail Rd, Carol Stream, IL 60188-9040 | 2020-09-02 |
| 1730790817 | Ih Fox Valley Opco, LLC | Skilled Nursing Facility | 4020 E New York St, Aurora, IL 60504-4416 | 2020-08-12 |
| 1902428147 | Aperion Care Glenwood LLC | Skilled Nursing Facility | 19330 South College Grove, Glenwood, IL 60425 | 2020-05-11 |
| 1487273330 | Residential Alternatives of Illinois, Inc | Skilled Nursing Facility | 2203 Flagg Rd, Rochelle, IL 61068 | 2020-04-10 |
| 1932728003 | Tco Jv, LLC | Skilled Nursing Facility | 550 Ridgeview Drive, Mchenry, IL 60050 | 2020-04-09 |
| 1841825510 | Ih Lisle Opco, LLC | Skilled Nursing Facility | 2850 Ogden Avenue, Lisle, IL 60532 | 2020-03-03 |
| 1114550381 | Rosiclare Hco, LLC | Skilled Nursing Facility | 55 Ferrell Rd, Rosiclare, IL 62982-1006 | 2020-02-17 |
| 1225672033 | All Ways Caring Services, Inc. | Skilled Nursing Facility | 301 N Neil St Ste 301, Champaign, IL 61820-3167 | 2019-11-05 |
| 1578036695 | Heartland Nursing & Rehabilitation LLC | Skilled Nursing Facility | 410 Nw 3rd St, Casey, IL 62420-1014 | 2019-01-11 |
| Find all providers with the same taxonomy | ||||
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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.