FIRESIDE HOUSE OF CENTRALIA
NPI 1346526134
Skilled Nursing Facility in Centralia, IL

Active since October 25, 2011
1030 MARTIN LUTHER KING DR, CENTRALIA, IL 62801(678) 522-2436(770) 663-4539 Get Directions Write a Review

NPPES record last updated: November 10, 2011. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Fireside House Of Centralia NPPES

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

FIRESIDE HOUSE OF CENTRALIA (NPI 1346526134) is a healthcare organization registered as a skilled nursing facility in Centralia, Illinois and active in the NPI registry since October 2011. The organization lists Daren G Douston, Member Cfo, as its authorized official.

NPPES Registry Identity

NPI1346526134
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameFIRESIDE-LTC, LLC
Location Address1030 MARTIN LUTHER KING DRCentralia, IL 62801-3002
Mailing Address10945 State Bridge Rd, Suite 401-470Alpharetta, GA 30022-8164 · (678) 522-2436 · Fax (770) 663-4539
Fax(770) 663-4539
Organization SubpartNo
Authorized OfficialDaren G DoustonMember Cfo · (678) 522-2436
Enumeration DateOctober 25, 2011
Last NPPES UpdateNovember 10, 2011
NPI 1346526134 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
Definition
(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.
1030 MARTIN LUTHER KING DR, Centralia, IL 62801

Other Names 1

Doing Business AsFireside House Of Centralia

Other Providers at the Same Location NPPES 2

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

Skilled Nursing Facility
1030 MARTIN LUTHER KING DR
CENTRALIA, IL 62801
Skilled Nursing Facility
1030 MARTIN LUTHER KING DR
CENTRALIA, IL 62801

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 Fireside-Ltc, LLC's NPI number?

The NPI number for Fireside-Ltc, LLC is 1346526134. It was assigned to this organization in the NPPES registry on October 25, 2011. The provider is doing business as Fireside House Of Centralia.

Where is Fireside-Ltc, LLC located?

Fireside-Ltc, LLC is located at 1030 Martin Luther King Dr, Centralia, IL 62801. The listed phone number is (678) 522-2436.

What is Fireside-Ltc, LLC's specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.

When was this NPI record last updated?

The NPPES record for Fireside-Ltc, LLC was last updated on November 10, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.