Organization
PHBV, LLC
Active
Other names
Bella Vista Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARALEE RUNGE (OFFICE MANAGER)
(847) 329-4100
Entity
Organization
Contact information
Practice address
1629 E GARDNER LN, PEORIA HEIGHTS, IL 61616-3613
(309) 685-1545
(309) 685-1571
Mailing address
7444 LONG AVE, SKOKIE, IL 60077-3214
(847) 329-4100
(847) 329-4900
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14-5811
MEDICARE
—
Enumeration date
04/09/2008
Last updated
09/14/2011
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