Phca, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

PHCA, LLC

Practice address

18540 State Highway 16
Lewistown, MO 63452-2111

Phone

(573) 215-2216

NPI assigned

Nov 9, 2010

Organization subpart

No

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

Authorized official

Name

Benjamin Klein

Title

Manager

Phone

(847) 329-4100

Specialties & licenses 2

Addresses

Other names 1

• Country Aire Retirement Estates Doing business as

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

{
    "created_epoch": "1289260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429056000000",
    "number": "1306147186",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18540 STATE HIGHWAY 16",
            "city": "LEWISTOWN",
            "state": "MO",
            "postal_code": "634522111",
            "telephone_number": "573-215-2216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHCA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-09",
        "last_updated": "2015-04-15",
        "status": "A",
        "authorized_official_last_name": "KLEIN",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "847-329-4100"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Country Aire Retirement Estates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tanya Lee Jones, MSW
• Lewis County Ambulance District
• Lewistown SNF Operations, LLC
• Josie L McCracken, PT
• Angela Obrien
• Kristi K Primm
• Quincy Physicians & Surgeons Clinic, PLLC
• Quincy Physicians & Surgeons Clinic, PLLC
• Alisha Elizabeth Schroeder, DPT

• All providers in Lewistown, MO
• Skilled Nursing Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2015; 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.