NPIMap

Organization Active NPI

Haven of Tuscola, LLC

  • Skilled Nursing Facility
  • Tuscola, IL
National Provider Identifier
1114746260
Registry record updated Mar 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
HAVEN OF TUSCOLA, LLC
Practice address
1203 Egyptian TRL
Tuscola, IL 61953-2050
Phone
(217) 253-4791
NPI assigned
Oct 7, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2025

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

Authorized official

Name
Mr. Levi Israel
Title
Ceo
Phone
(847) 905-3000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

1203 Egyptian TRL
Tuscola, IL 61953-2050

Mailing address

2201 Main St
Evanston, IL 60202-1519
Phone (847) 905-3220

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250317000343 IL Part A Provider - Skilled Nursing Facility 4688196975 Practice locations: Tuscola, IL

Skilled nursing facility certification: CCN 146086

Legal name
HAVEN OF TUSCOLA LLC
Doing business as
THE HAVEN OF TUSCOLA
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jul 1, 2005
Last certification
Jan 28, 2025
Beds
73 (71 certified)
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Haven Healthcare Holdings
Organization structure
LLCProprietary
Enrollment address
1203 Egyptian TRL
Tuscola, IL 61953-2050
Nursing home name
THE HAVEN OF TUSCOLA
Affiliated entity
HAVEN HEALTHCARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
The Haven of TuscolaCCN 146086
Overall star rating
1 of 5
Health inspections
1 of 5
Staffing
1 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Jul 1, 2005
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
7148.5 residents per day on average
Chain
Haven Healthcare7 facilities in the chain
Penalties (3 years)
3Fines totaling $68,631

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D0433185Haven of Tuscola, LLC, the1203 Egyptian Trail, Tuscola, IL 61953Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 18

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Haven Healthcare Holdings LLC Organization, Evanston, IL LLC, Holding company, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Dec 1, 2024 99.99%
5% Or Greater Indirect Ownership Interest Dec 1, 2024 0.01%
Syndey Robinson Individual Operational/Managerial Control Dec 1, 2024
Adp of the SNF Dec 1, 2024
Ecapital Healthcare Corp Organization, Aventura, FL Corporation, Financial institution, Owned by another organization or individual 5% Or Greater Security Interest Dec 1, 2024 100%
Operational/Managerial Control Mar 1, 2025
William Rothner Individual Trustee of the SNF Dec 1, 2024
David Glat Individual 5% Or Greater Indirect Ownership Interest Dec 1, 2024 40%
Operational/Managerial Control Dec 1, 2024
Managing Control - Governing BodyManager Dec 1, 2024
Adp of the SNF Dec 1, 2024
Organization, Evanston, IL LLC, Holding company, Owned by another organization or individual Direct Ownership Interest Dec 1, 2024 0.01%
Asad Zaman Individual Operational/Managerial Control Dec 1, 2024
Adp of the SNF Dec 1, 2024
Organization, Evanston, IL LLC Adp of the SNF Dec 1, 2024
Organization, San Clemente, CA Corporation, Real estate investment trust (REIT) Adp of the SNF Dec 1, 2024
Organization, Evanston, IL LLC Adp of the SNF Dec 1, 2024
Nathan and Shirley Rothner Family Trust Organization, Evanston, IL 5% Or Greater Indirect Ownership Interest Dec 1, 2024 40%
Organization, San Clemente, CA Adp of the SNF Dec 1, 2024
Harold Katz Individual Trustee of the SNF Dec 1, 2024
Organization, Skokie, IL LLC, Holding company Adp of the SNF Apr 21, 2025
Organization, Chicago, IL Adp of the SNF Dec 1, 2024
Haven Healthcare LLC Organization, Evanston, IL LLC, Chain home office Adp of the SNF Dec 1, 2024
Individual Adp of the SNF Dec 1, 2024
Levi Israel Individual 5% Or Greater Indirect Ownership Interest Dec 1, 2024 20%
Adp of the SNF Dec 1, 2021

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 26

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1728259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741305600000",
    "number": "1114746260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 MAIN ST",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602021519",
            "telephone_number": "847-905-3220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1203 EGYPTIAN TRL",
            "city": "TUSCOLA",
            "state": "IL",
            "postal_code": "619532050",
            "telephone_number": "217-253-4791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAVEN OF TUSCOLA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-07",
        "last_updated": "2025-03-07",
        "certification_date": "2025-03-07",
        "status": "A",
        "authorized_official_last_name": "ISRAEL",
        "authorized_official_first_name": "LEVI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "847-905-3000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tuscola, IL

Sources for this page

Verify at the official NPI Registry.