Organization
HAVEN OF WABASH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LEVI ISRAEL (CEO)
(847) 905-3283
Entity
Organization
Contact information
Practice address
320 S 2ND ST, GRAYVILLE, IL 62844-1527
(618) 375-1371
Mailing address
2201 MAIN ST, EVANSTON, IL 60202-1519
(773) 989-3000
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
08/28/2025
Last updated
08/28/2025
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