Organization
PHAV, LLC
Active
Other names
LaVerna Village of St Joseph
Organization subpart
No
Provider details
NPI number
Authorized official
BENJAMIN KLEIN (MANAGER)
(847) 329-4100
Entity
Organization
Contact information
Practice address
1317 N 36TH ST, SAINT JOSEPH, MO 64506-2359
(816) 676-1630
Mailing address
7444 LONG AVE, SKOKIE, IL 60077-3214
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
07/12/2013
Last updated
04/15/2015
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