Healthcare Provider Details

I. General information

NPI: 1982855052
Provider Name (Legal Business Name): HELIA SOUTHBELT HEALTHCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2008
Last Update Date: 03/18/2024
Certification Date: 03/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 S BELT W
BELLEVILLE IL
62220-2503
US

IV. Provider business mailing address

500 NW PLAZA DR STE 712
SAINT ANN MO
63074-2222
US

V. Phone/Fax

Practice location:
  • Phone: 618-277-7700
  • Fax:
Mailing address:
  • Phone: 314-566-0459
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number0048587
License Number StateIL

VIII. Authorized Official

Name: STEVEN P MILLER
Title or Position: PRINCIPAL / OWNER
Credential:
Phone: 314-431-0511