Healthcare Provider Details

I. General information

NPI: 1932487832
Provider Name (Legal Business Name): BELLEVIEW VALLEY SKILLED NURSING CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2011
Last Update Date: 08/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23144 HIGHWAY 32
BELLEVIEW MO
63623-6346
US

IV. Provider business mailing address

23144 HIGHWAY 32
BELLEVIEW MO
63623-6346
US

V. Phone/Fax

Practice location:
  • Phone: 573-697-5311
  • Fax: 573-697-5389
Mailing address:
  • Phone: 573-697-5311
  • Fax: 573-697-5389

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: PATRICIA ANDERSON
Title or Position: OFFICE MANAGER
Credential:
Phone: 573-546-1616