Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Fireside-Ltc, LLC

Organization Skilled Nursing Facility · NPI 1346526134

Fireside-Ltc, LLC is a Skilled Nursing Facility in Centralia, Illinois. Registered with an NPI since 2011.

In the registry since
2011
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1030 Martin Luther King Dr
Centralia, IL 62801-3002
Phone: (678) 522-2436
Fax: (770) 663-4539
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Skilled Nursing Facility (primary) Taxonomy 314000000X

Record details

NPI number1346526134
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Daren Douston — Member Cfo · (678) 522-2436
Other names Fireside House Of Centralia
NPI enumeratedOctober 25, 2011
Last updated in NPPESNovember 10, 2011
Mailing address10945 State Bridge Rd, Suite 401-470, Alpharetta, GA 30022-8164

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