Ltc of Illinois - Fireside, Inc
Ltc of Illinois - Fireside, Inc is a Skilled Nursing Facility in Centralia, Illinois. Licensed in Illinois. Registered with an NPI since 2006.
- Licensed in
- IL
- In the registry since
- 2006
What do these letters mean?
- Inc — Incorporated
- A form of business registration, not a clinical qualification.
Practice location Address checks out
1030 Martin Luther King DrCentralia, IL 62801-3002 Not confirmed with CMS for 18 years — call before visiting
Phone: (618) 532-1833
Fax: (618) 532-1308
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Skilled Nursing Facility (primary) | Taxonomy 314000000X · Licence 0045690 (IL) |
|---|
Record details
| NPI number | 1700819778 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Douglas Mittleider — President · (770) 619-0866 |
| Other names | Fireside House Of Centralia |
| NPI enumerated | July 10, 2006 |
| Last updated in NPPES | April 20, 2008 |
| Mailing address | 1030 Martin Luther King Dr, Centralia, IL 62801-3002 |
Clinicians affiliated with this facility
- Dr. Suresh Krishnamoorthy, MD Geriatric Medicine (Internal Medicine) Physician · Centralia, IL
- Mr. Aziz U Rahman, MD Pulmonary Disease Physician · Centralia, IL
- Niranjan Shrestha, MD, FAAFP Family Medicine Physician · Centralia, IL
- Dr. Rajendra R Shroff, MD Internal Medicine Physician · Centralia, IL
- Misty Dawn Wernsman, FNP Gerontology Nurse Practitioner · Centralia, IL
Other providers in Centralia
-
Fireside-Ltc, LLC
1030 Martin Luther King Dr, Centralia, IL 62801-3002 · (678) 522-2436
-
Friendship-Ltc, LLC
1000 Martin Luther King Dr, Centralia, IL 62801-3002 · (678) 522-2436
-
Hcc-Healthcare Properties, LLC
1030 Martin Luther King Dr, Centralia, IL 62801-3002 · (618) 532-1308
-
Ltc Illinois - Friendship, Inc
1000 Martin Luther King, Centralia, IL 62801 · (618) 532-3642
-
Unlimited Development Inc
1910 E McCord, Centralia, IL 62801-6586 · (618) 533-1200