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

Ltc of Illinois - Fireside, Inc

Organization Skilled Nursing Facility · NPI 1700819778

Ltc of Illinois - Fireside, Inc is a Skilled Nursing Facility in Centralia, Illinois. Medicare rates this nursing home 3 out of 5. Licensed in Illinois.

CMS rating
3 of 5
Licensed in
IL
In the registry since
2006
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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CMS quality rating

3 out of 5 — official nursing home rating from CMS Care Compare (CCN 145791)
Health inspection3.0 / 5
Staffing3.0 / 5
Quality measures2.0 / 5
OwnershipFor profit - Individual

Practice location Address checks out

1030 Martin Luther King Dr
Centralia, IL 62801-3002
Phone: (618) 532-1833
Fax: (618) 532-1308
Show map & directions

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

Specialties & licences

Skilled Nursing Facility (primary) Taxonomy 314000000X · Licence 0045690 (IL)

Record details

NPI number1700819778
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Douglas Mittleider — President · (770) 619-0866
Other names Fireside House Of Centralia
NPI enumeratedJuly 10, 2006
Last updated in NPPESApril 20, 2008
Mailing address1030 Martin Luther King Dr, Centralia, IL 62801-3002

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