PHBV, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

PHBV, LLC

Practice address

1629 E Gardner LN
Peoria Heights, IL 61616-3613

Phone

(309) 685-1545

Fax

(309) 685-1571

NPI assigned

Apr 9, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Maralee Runge

Title

Office Manager

Phone

(847) 329-4100

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Bella Vista Care Center Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1207699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315958400000",
    "number": "1043483118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7444 LONG AVE",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600773214",
            "telephone_number": "847-329-4100",
            "fax_number": "847-329-4900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1629 E GARDNER LN",
            "city": "PEORIA HEIGHTS",
            "state": "IL",
            "postal_code": "616163613",
            "telephone_number": "309-685-1545",
            "fax_number": "309-685-1571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHBV, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-09",
        "last_updated": "2011-09-14",
        "status": "A",
        "authorized_official_last_name": "RUNGE",
        "authorized_official_first_name": "MARALEE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "847-329-4100",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "14-5811",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bella Vista Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Veronica Patel, PHARMD
• Kelly Jo Paulsen, MS CCC-SLP
• Peoria Heights Cu SCH Dist 325
• Peoria Heights Nursing and Rehab LLC
• Peoria Heights Nursing and Rehab LLC
• Rose Garden Care Center Inc.
• Hannah S. Schultz, OTD, OTR/L
• Lisa M Schwab, LCPC
• Sharshon Pharmacy. Inc.
• Jennifer A Siefert, RPH

• Skilled Nursing Facility in Peoria Heights, IL
• Providers in Peoria Heights, IL by specialty
• Skilled Nursing Facility in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.