NPIMap

Organization Active NPI

Bethesda Long Term Care, Inc.

  • Skilled Nursing Facility
  • St. Louis, MO
National Provider Identifier
1073673828
Registry record updated Jan 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
BETHESDA LONG TERM CARE, INC.
Practice address
4431 South Broadway
St. Louis, MO 63111
Phone
(314) 481-4840
Fax
(314) 481-1014
NPI assigned
Dec 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Joseph J Brinker
Title
Executive Vice President
Phone
(314) 800-1986

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Custodial Care Facility 311Z00000X
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

4431 South Broadway
St. Louis, MO 63111

Mailing address

4431 South Broadway
St. Louis, MO 63111
Phone (314) 481-4840

Other names 1

  • The Charless Home Doing business as

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327363200000",
    "number": "1073673828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4431 SOUTH BROADWAY",
            "city": "ST. LOUIS",
            "state": "MO",
            "postal_code": "63111",
            "telephone_number": "314-481-4840",
            "fax_number": "314-481-1014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4431 SOUTH BROADWAY",
            "city": "ST. LOUIS",
            "state": "MO",
            "postal_code": "63111",
            "telephone_number": "314-481-4840",
            "fax_number": "314-481-1014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETHESDA LONG TERM CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-11",
        "last_updated": "2012-01-24",
        "status": "A",
        "authorized_official_last_name": "BRINKER",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT",
        "authorized_official_telephone_number": "314-800-1986",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "311Z00000X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Charless Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in St. Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.