Organization Active NPI

The Haven on the River, LLC

  • Skilled Nursing Facility
  • Grayville, IL
National Provider Identifier
1205707676
Registry record updated Oct 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
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, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2025

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)CodeLicenseStatePrimary
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 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
14D2339711Haven on the River320 S 2ND St, Grayville, IL 62844Certificate of waiverMar 4, 2028

National Provider Directory

National Provider Directory

Locations

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.

Verify at the official NPI Registry.