Havana Hco, LLC

Skilled Nursing Facility · Havana, IL

Organization Active NPI

NPI number 1760015929

Practice location

609 N Harpham St
Havana, IL 62644-1249
Phone
(309) 543-6121

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NPI record

NPI
1760015929
Entity type
Organization (Type 2)
Enumeration date
February 17, 2020
Last updated
February 17, 2020
Certified
February 17, 2020
Organization subpart
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Skilled Nursing Facility Primary 314000000X — —

Mailing address

830 W Trailcreek Dr
Peoria, IL 61614-1862
Phone
(309) 689-5880

Authorized official

Name
Mark B. Petersen
Title
Manager
Phone
(309) 691-8113

About Havana Hco, LLC

Havana Hco, LLC is a healthcare organization registered in the NPI registry with the primary taxonomy Skilled Nursing Facility (code 314000000X). The practice location is 609 N Harpham St, Havana, IL 62644-1249. The NPI number 1760015929 was assigned on February 17, 2020 and the record was last updated on February 17, 2020.

The authorized official for this organization is Mark B. Petersen, Manager.

Frequently asked questions

What is the NPI number of Havana Hco, LLC?

The NPI number is 1760015929.

What is the phone number of Havana Hco, LLC?

The phone number listed for the practice location is (309) 543-6121.

Where is Havana Hco, LLC located?

609 N Harpham St, Havana, IL 62644-1249.

What is the taxonomy code for Havana Hco, LLC?

The primary taxonomy code is 314000000X – Skilled Nursing Facility.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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