PARK PLACE
NPI 1508086810
Intermediate Care Facility, Intellectual Disabilities in Centralia, IL

Active since April 27, 2007
332 COUNTRY CLUB RD, CENTRALIA, IL 62801(618) 533-7922 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Park Place NPPES

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

PARK PLACE (NPI 1508086810) is a healthcare organization registered as an intermediate care facility, intellectual disabilities in Centralia, Illinois and active in the NPI registry since April 2007. The organization lists Georgia Miller, Ceo, as its authorized official.

NPPES Registry Identity

NPI1508086810
Entity TypeOrganization
Primary Taxonomy315P00000X
Legal Business NamePENTA NASCENT CORPORATION
Location Address332 COUNTRY CLUB RDCentralia, IL 62801-3742
Mailing AddressPo Box 1690Centralia, IL 62801-9124
Organization SubpartNo
Authorized OfficialGeorgia MillerCeo · (618) 548-4561
Enumeration DateApril 27, 2007
Last NPPES UpdateAugust 22, 2020
NPI 1508086810 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyIntermediate Care Facility, Intellectual DisabilitiesNursing & Custodial Care Facilities
Taxonomy Code315P00000X
License Licensed in IL · 0038646
Definition
An intermediate care facility providing services for individuals with intellectual disabilities.
332 COUNTRY CLUB RD, Centralia, IL 62801

Other Names 1

Doing Business AsPark Place

Other Identifiers 1

Medicaid14G298IL

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 Penta Nascent Corporation's NPI number?

The NPI number for Penta Nascent Corporation is 1508086810. It was assigned to this organization in the NPPES registry on April 27, 2007. The provider is doing business as Park Place.

Where is Penta Nascent Corporation located?

Penta Nascent Corporation is located at 332 Country Club Rd, Centralia, IL 62801. The listed phone number is (618) 533-7922.

What is Penta Nascent Corporation's specialty?

The primary specialty registered for this NPI is Intermediate Care Facility, Intellectual Disabilities with taxonomy code 315P00000X.

When was this NPI record last updated?

The NPPES record for Penta Nascent Corporation was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.