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HAVANA HEALTH CARE CENTER
NPI 1235380478
Nursing Facility/Intermediate Care Facility in Havana, IL

Active since October 07, 2008CLIA 10D0667777 · Waiver
1/5
Overall Rating
609 N HARPHAM ST, HAVANA, IL 62644(309) 543-6121 Get Directions Write a Review

NPPES record last updated: October 7, 2008. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Havana Health Care Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

HAVANA HEALTH CARE CENTER (NPI 1235380478) is a healthcare organization registered as a nursing facility/intermediate care facility in Havana, Illinois and active in the NPI registry since October 2008. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists Mark Petersen, President, as its authorized official.

NPPES Registry Identity

NPI1235380478
Entity TypeOrganization
Primary Taxonomy313M00000X
Legal Business NamePETERSEN HEALTH CARE INC
Location Address609 N HARPHAM STHavana, IL 62644-1249
Mailing Address830 W Trailcreek DrPeoria, IL 61614-1862 · (309) 691-8113
Phone(309) 543-6121
Organization SubpartNo
Authorized OfficialMark PetersenPresident · (309) 691-8113
Enumeration DateOctober 7, 2008
✔ NPI 1235380478 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNursing Facility/Intermediate Care FacilityNursing & Custodial Care Facilities
Taxonomy Code313M00000X
License✔ Licensed in IL · 0046086
Definition
An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals.
609 N HARPHAM ST, Havana, IL 62644
Open in Google Maps ↗

Other Names 1

Doing Business AsHavana Health Care Center

Other Identifiers 1

Medicaid=========022IL

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D0667777

Havana Health Care Center · Havana, IL
Active · expires Aug 31, 2026
CLIA Number10D0667777
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorSherry L. Miller
Laboratory Phone(309) 543-6121
Laboratory LocationHavana Health Care Center609 N Harpham St, Havana, IL 62644
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Nursing Home Quality Ratings CMS Care Compare

Quality ratings, staffing and inspection history for Havana Health Care Center (CMS certification number 145774), from CMS Care Compare.

Havana Health Care Center

Nursing home · Havana, IL
1/5 CMS Overall Rating
OwnershipFor profit - Corporation
CMS Certification Number145774
Certified Beds98 beds35 residents per day on average
Medicare & Medicaid Participant SinceFebruary 1, 1994
Resident & Family CouncilResident council
Automatic sprinkler system

CMS Star Ratings

Quality Measures
Based on a select set of clinical quality measures.
1/5
Long-Stay Quality
Quality of care delivered to long-term residents.
1/5
Staffing
Based on nursing staff hours relative to resident needs.
1/5
Weighted Health Inspection Score
Lower scores are better; the score summarizes deficiencies found on recent inspections.
416.33
Ratings are assigned by CMS on a one-to-five star scale; five is the highest. Categories without a current CMS rating are not shown.

Staffing & Turnover

Total Nurse Staffing
nurse aide 1.94 · LPN 0.53 · RN 0
2.47 hrs per resident per day
Weekend Nurse Staffing
2.46 hrs per resident per day
Physical Therapist Staffing
0.01 hrs per resident per day
Nursing Staff Turnover
Share of nursing staff who left the facility within the past year.
48.6%
Administrators Who Have Left
In the past year.
0
Higher staffing hours generally allow more direct care time per resident.

Inspections & Enforcement

CMS has flagged this facility with its abuse flag, indicating a citation for abuse or neglect on a recent inspection report.
CMS lists this facility in its Special Focus Facility program, which identifies nursing homes with a persistent pattern of inspection issues for increased oversight.
Facility-Reported Incidents
9
Substantiated Complaints
17
Infection-Control Citations
7
Fines
1 totaling $6,500.00
Medicare Payment Denials
0
Total Penalties
1
Counts come from CMS inspections and complaint investigations over approximately the past three years. CMS Care Compare data as of October 1, 2024.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HAVANA HCO, LLC
Skilled Nursing Facility
609 N HARPHAM ST
HAVANA, IL 62644
Mason County (309) 543-6121
SARAH SALSMAN PTA
Physical Therapy Assistant
609 N HARPHAM ST
HAVANA, IL 62644
Mason County (309) 543-6121
HAVANA HCO, LLC
Skilled Nursing Facility
609 N HARPHAM ST
HAVANA, IL 62644
Mason County (309) 543-6121
ARCADIA CARE HAVANA LLC
Durable Medical Equipment & Medical Supplies
609 N HARPHAM ST
HAVANA, IL 62644
Mason County (309) 543-6121
ARCADIA CARE HAVANA LLC
Skilled Nursing Facility
609 N HARPHAM ST
HAVANA, IL 62644
Mason County (309) 543-6121

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Petersen Health Care Inc's NPI number?

The NPI number for Petersen Health Care Inc is 1235380478. It was assigned to this organization in the NPPES registry on October 7, 2008. The provider is doing business as Havana Health Care Center.

Where is Petersen Health Care Inc located?

Petersen Health Care Inc is located at 609 N Harpham St, Havana, IL 62644. The listed phone number is (309) 543-6121.

What is Petersen Health Care Inc's specialty?

The primary specialty registered for this NPI is Nursing Facility/Intermediate Care Facility with taxonomy code 313M00000X.

Does Petersen Health Care Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D0667777) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

Is Petersen Health Care Inc a Medicare-certified nursing home?

Yes. Havana Health Care Center is a Medicare-certified nursing home with 98 certified beds.

What quality rating does Petersen Health Care Inc have?

CMS rates Havana Health Care Center 1 out of 5 stars overall on Care Compare. The full measure detail is in the Nursing Home Quality Ratings section above.

When was this NPI record last updated?

The NPPES record for Petersen Health Care Inc was last updated on October 7, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.