Active NPI
The Haven on the River, LLC
- Skilled Nursing Facility
- Grayville, IL
National Provider Identifier
1205707676
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- THE HAVEN ON THE RIVER, LLC
- Practice address
- 320 S 2ND St
Grayville, IL 62844-1527 - Phone
- (618) 375-2171
- NPI assigned
- Sep 17, 2025
- Last updated
- Oct 30, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. James Gregory
- Title
- Cfo
- Phone
- (847) 905-3220
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Primary |
Addresses
Primary practice location
320 S 2ND St
Grayville, IL 62844-1527
Mailing address
2201 Main St
Evanston, IL 60202-1519
Phone (847) 905-3220
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 14D2339711 | Haven on the River | Certificate of waiver | Mar 4, 2028 |
National Provider Directory
National Provider DirectoryLocations
320 S 2nd St
Grayville, IL 62844
Phone (618) 375-1371
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1758067200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1761782400000",
"number": "1205707676",
"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": "320 S 2ND ST",
"city": "GRAYVILLE",
"state": "IL",
"postal_code": "628441527",
"telephone_number": "618-375-2171"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "THE HAVEN ON THE RIVER, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2025-09-17",
"last_updated": "2025-10-30",
"certification_date": "2025-10-30",
"status": "A",
"authorized_official_last_name": "GREGORY",
"authorized_official_first_name": "JAMES",
"authorized_official_title_or_position": "CFO",
"authorized_official_telephone_number": "847-905-3220",
"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 Grayville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.