Healthcare Provider Details

I. General information

NPI: 1447415914
Provider Name (Legal Business Name): BABAR ENTERPRISES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2008
Last Update Date: 06/02/2025
Certification Date: 06/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 MEXICO RD STE 104
SAINT PETERS MO
63376-1666
US

IV. Provider business mailing address

607 DEWEY AVE NW STE 300
GRAND RAPIDS MI
49504-7335
US

V. Phone/Fax

Practice location:
  • Phone: 636-887-3660
  • Fax:
Mailing address:
  • Phone: 616-356-5000
  • Fax: 616-356-5001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2832
License Number StateMO

VIII. Authorized Official

Name: RICHARD LEAVER
Title or Position: CEO
Credential:
Phone: 616-356-5000