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General NPI Number Information
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NPI Number | 1750357950
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Entity Type | Organization
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Legal Business Name | BETHESDA LONG TERM CARE, INC.
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Dates
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Enumeration Date | 02/27/2006
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Last Update Date | 05/28/2025
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Provider Practice Location Address
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Address Line | 5943 TELEGRAPH RD
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City | SAINT LOUIS
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State | MO
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Zip | 63129-4715
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Country | US
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Telephone | 314-846-2000
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Fax | 314-846-4661
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Provider Business Mailing Address
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Address Line | 12101 WOODCREST EXECUTIVE DR STE 200
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City | SAINT LOUIS
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State | MO
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Zip | 63141-5047
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Country | US
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Telephone | 314-800-1900
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Fax | 314-900-3683
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MR. JOSEPH J BRINKER
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Credential |
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Telephone | 314-800-1986
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 032167
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License Number State | MO
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