Park Haven Care Center

LBN: Beverly Enterprises - Illinois, Inc.
Park Haven Care Center is an health care organization with primary practice located at 107 S. Lincoln , Smithton IL 62285. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Skilled Nursing Facility, which is considered as the primary health care specialty. Beverly Enterprises - Illinois, Inc. can be contacted via phone (618) 235-4600, or through Merrell, David via phone (479) 201-4840.

Contact Information

Primary practice address
107 S. Lincoln Smithton IL 62285
Phone: (618) 235-4600
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Merrell, David
Phone: (479) 201-4840

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Skilled Nursing Facility 314000000X

Profile Details

NPI number 1265526818
LBN Legal business name Beverly Enterprises - Illinois, Inc.
DBA Doing business as Park Haven Care Center
Authorized official Merrell, David
Entity Organization
Organization subpart 1 No
Enumeration date Oct 3rd, 2006
Last updated Aug 22nd, 2020 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1265526818 NPPES
Illinois MEDICAID 95-2301514017

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