Park Haven Nursing & Rehabilitation Center LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

PARK HAVEN NURSING & REHABILITATION CENTER LLC

Doing business as

Integrity Healthcare of Smithton

Practice address

107 South Lincoln
Smithton, IL 62285-1617

Phone

(618) 235-4600

Fax

(618) 235-5829

NPI assigned

May 29, 2007

Organization subpart

No

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

Authorized official

Name

Steven Blisko

Title

Manager

Phone

(708) 426-2315

Specialties & licenses 1

Addresses

Other names 1

• Integrity Healthcare of Smithton Doing business as

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

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551916800000",
    "number": "1487855581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4213 MAIN STREET",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600762046",
            "telephone_number": "708-236-0000",
            "fax_number": "708-236-0001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 SOUTH LINCOLN",
            "city": "SMITHTON",
            "state": "IL",
            "postal_code": "622851617",
            "telephone_number": "618-235-4600",
            "fax_number": "618-235-5829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK HAVEN NURSING & REHABILITATION CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-29",
        "last_updated": "2019-03-07",
        "status": "A",
        "authorized_official_last_name": "BLISKO",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "708-426-2315"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Integrity Healthcare of Smithton",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Integrity Healthcare of Smithton",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Smithton, IL
• Providers in Smithton, 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 Mar 7, 2019; 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.