PETERSEN HEALTH QUALITY, LLC (NPI# 1598721383) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598721383 |
| Entity Type | Organization |
| Organization Name | PETERSEN HEALTH QUALITY, LLC |
| Other Organization Name | COUNTRYVIEW TERRACE |
| Practice Address |
52 Old Rte 45 Louisville IL 62858-0116 |
| Mailing Address |
830 W Trailcreek Dr Peoria IL 61614-1862 |
| Practice Telephone | 6186864542 |
| Practice Fax Number | 6186862179 |
| Mailing Telephone | 3096918113 |
| Mailing Fax Number | 3096918622 |
| Enumeration Date | 2006-04-21 |
| Last Update Date | 2014-10-12 |
| Authorized Official Name | MARK B. PETERSEN (PRESIDENT) |
| Authorized Official Telephone | 3096918113 |
| Is Organization Subpart | Y |
| Parent Organization Name | PETERSEN HEALTH CARE, INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 315P00000X | Intermediate Care Facility, Mentally Retarded | 0046078 | IL | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 37-1068286008 | 05 |
| Other Name | Type Code |
|---|---|
| Countryview Terrace | Doing Business As Name - Organization |
| Street Address |
52 OLD RTE 45 |
| City | LOUISVILLE |
| State | IL |
| Zip Code | 62858-0116 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144793928 | Grace & Truth Counseling, LLC | Counselor | 235 Chestnut St., Louisville, IL 62858 | 2019-01-04 |
| 1821327453 | Cara Margaret Rinehart | Counselor | 125 Broadway St, Louisville, IL 62858 | 2009-12-10 |
| 1437290798 | Family Health Clinic | Clinic/Center | 134 S. Church St., Louisville, IL 62858 | 2007-02-09 |
| 1528154044 | North Clay Cu School Dist 25 | Local Education Agency (LEA) | 953 Kinmundy Rd, Louisville, IL 62858 | 2006-10-04 |
| 1427068998 | Brittani Leah Riggio | Chiropractor | 101 S. Main Street, Louisville, IL 62858 | 2006-08-08 |
| 1922170844 | William S Harrison | Chiropractor | 101 S. Main St., Louisville, IL 62858 | 2006-11-15 |
| 1225114846 | Back & Body Works | Chiropractor | 101 South Main Street, Louisville, IL 62858 | 2006-10-27 |
| 1669669503 | North Clay Family Chiropractic,pc | Chiropractor | 101 South Main Street, Louisville, IL 62858-0009 | 2007-09-25 |
| 1669791950 | Zinks Transportation Services | Taxi | 150 S Route 45, Louisville, IL 62858-0250 | 2010-05-26 |
| 1134750243 | Trinity Health and Wellness, LLC. | Clinic/Center | 850 Bryant St, Louisville, IL 62858-1000 | 2020-01-28 |
| Find all providers in zip 62858 | ||||
| Taxonomy Code | 315P00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Intermediate Care Facility, Mentally Retarded |
| (1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals. |
| Notes: Sources: (1) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 403 (2) Paraphrased from Code of Federal Regulations #42, Public Health, Section 440.150(c). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306017439 | The Academy for Individual Excellence, Inc. | Intermediate Care Facility, Mentally Retarded | 3101 Bluebird Ln, Louisville, KY 40299-3803 | 2008-03-17 |
| 1538356712 | Voca Corporation of Ohio | Intermediate Care Facility, Mentally Retarded | 4230 Lesh St, Louisville, OH 44641-8605 | 2007-10-01 |
| 1083785125 | Commonwealth of Kentucky | Intermediate Care Facility, Mentally Retarded | 4401-4505 Louise Underwood Way, Louisville, KY 40216 | 2006-11-12 |
| 1043298979 | Commonwealth of Kentucky | Intermediate Care Facility, Mentally Retarded | 5512 Del Maria Way, Louisville, KY 40291-1810 | 2005-12-30 |
| 1316241961 | Southern Home Care Services, Inc. | Intermediate Care Facility, Mentally Retarded | 9901 Linn Station Rd, Louisville, KY 40223-3808 | 2010-12-22 |
| 1275836124 | Southern Home Care Services, Inc. | Intermediate Care Facility, Mentally Retarded | 9901 Linn Station Rd, Louisville, KY 40223-3808 | 2010-12-15 |
| 1922233469 | Rscr California, Inc. | Intermediate Care Facility, Mentally Retarded | 9901 Linn Station Rd, Louisville, KY 40223-3808 | 2009-05-28 |
| 1467624288 | Voca Corporation of Florida | Intermediate Care Facility, Mentally Retarded | 9901 Linn Station Rd, Louisville, KY 40223-3808 | 2008-04-01 |
| 1700057833 | Alternative Youth Services, Inc. | Intermediate Care Facility, Mentally Retarded | 200 High Rise Dr, Suite 155, Louisville, KY 40213-3252 | 2008-03-17 |
| 1033197967 | Commonwealth of Kentucky | Intermediate Care Facility, Mentally Retarded | 1800 Bluegrass Ave, Louisville, KY 40215-1130 | 2005-12-30 |
| Find all providers in LOUISVILLE | ||||
| City | LOUISVILLE |
| Zip Code | 62858 |
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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.