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COURTYARD VILLAGE OF KEWANEE
NPI 1740362979
Assisted Living Facility in Kewanee, IL

Active since October 19, 2006CLIA 14D2192578 · Waiver
808 SUNSET DRIVE, KEWANEE, IL 61443(309) 853-4044(309) 853-5014 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Courtyard Village Of Kewanee NPPES

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

COURTYARD VILLAGE OF KEWANEE (NPI 1740362979) is a healthcare organization registered as an assisted living facility in Kewanee, Illinois and active in the NPI registry since October 2006. The organization holds a CLIA Waiver certificate valid through September 10, 2026 and lists Mark B Petersen, President, as its authorized official.

NPPES Registry Identity

NPI1740362979
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NamePETERSEN HEALTH SYSTEMS, INC
Location Address808 SUNSET DRIVEKewanee, IL 61443
Mailing Address830 W Trailcreek DrPeoria, IL 61614-1862 · (309) 691-8113 · Fax (309) 691-8622
Phone(309) 853-4044
Fax(309) 853-5014
Organization SubpartNo
Authorized OfficialMark B PetersenPresident · (309) 691-8113
Enumeration DateOctober 19, 2006
Last NPPES UpdateAugust 22, 2020
✔ NPI 1740362979 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
License✔ Licensed in IL · 5101537
Definition
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.
808 SUNSET DRIVE, Kewanee, IL 61443
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Other Names 1

Doing Business AsCourtyard Village Of Kewanee

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 14D2192578

Courtyard Village Of Kewanee · Kewanee, IL
Active · expires Sep 10, 2026
CLIA Number14D2192578
Laboratory TypeAssisted Living Facility
Certificate Effective DateSeptember 11, 2024
Certificate Expiration DateSeptember 10, 2026
Laboratory DirectorShawna Cassidy
Laboratory Phone(309) 853-4044
Laboratory LocationCourtyard Village Of Kewanee860 Sunset Dr, Kewanee, IL 61443
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Systems, Inc's NPI number?

The NPI number for Petersen Health Systems, Inc is 1740362979. It was assigned to this organization in the NPPES registry on October 19, 2006. The provider is doing business as Courtyard Village Of Kewanee.

Where is Petersen Health Systems, Inc located?

Petersen Health Systems, Inc is located at 808 Sunset Drive, Kewanee, IL 61443. The listed phone number is (309) 853-4044.

What is Petersen Health Systems, Inc's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Does Petersen Health Systems, Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D2192578) is associated with this NPI, valid through September 10, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Petersen Health Systems, Inc 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.