Healthcare Provider Details

I. General information

NPI: 1114551694
Provider Name (Legal Business Name): BELLEVIEW INVESTMENT GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/24/2020
Last Update Date: 02/24/2020
Certification Date: 02/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23144 HIGHWAY 32
BELLEVIEW MO
63623-6346
US

IV. Provider business mailing address

PO BOX 91
IRONTON MO
63650-0091
US

V. Phone/Fax

Practice location:
  • Phone: 573-697-5311
  • Fax:
Mailing address:
  • Phone: 573-546-1616
  • Fax: 573-546-6465

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: MRS. BROOKE MICHELLE BIGHAM
Title or Position: MANAGER
Credential:
Phone: 417-425-3062