Healthcare Provider Details

I. General information

NPI: 1932400728
Provider Name (Legal Business Name): PHBS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2010
Last Update Date: 04/15/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 E MILL ST
HUMANSVILLE MO
65674-8507
US

IV. Provider business mailing address

7444 LONG AVE
SKOKIE IL
60077-3214
US

V. Phone/Fax

Practice location:
  • Phone: 417-754-8711
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: BENJAMIN KLEIN
Title or Position: MANAGER
Credential:
Phone: 847-329-4100