Bleauridge Nursing and Rehab LLC
Organization Active NPI Skilled Nursing Facility · Belton, MO
NPI 1245068154 · NPPES record last updated Jul 23, 2024
Key facts
- NPI
- 1245068154
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- Legal business name
- BLEAURIDGE NURSING AND REHAB LLC
- Practice address
- 1003 Cedar St
Belton, MO 64012 - Phone
- (816) 331-0781
- NPI assigned
- Jul 23, 2024
- Organization subpart
- No
Authorized official
- Name
- Mr. Shafiq Malik
- Title
- President
- Phone
- (573) 335-3044
Owners & managing parties with NPI records 1
-
Brian Moore Haas, D.O
Corporate family (same tax ID) 1
Facilities with the same owner 87
Practitioners 1
-
Brian Moore Haas, D.O
Affiliated clinicians 1
-
Brian Moore Haas, D.O
Medicare Care Compare: Nursing home
- Listed as
- Beautiful Savior Home
- Overall star rating
- ★★★☆☆ 3 of 5
- Health inspections
- ★★★☆☆ 3 of 5
- Staffing
- ★★☆☆☆ 2 of 5
- Quality measures
- ★★★☆☆ 3 of 5
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Apr 26, 2004
- Medicare certification status
- Active
- Certified beds
- 126 · 79.3 residents per day on average
- Chain
- Shafiq Malik
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
Skilled nursing facility certification: CCN 265782
- Legal name
- BLEAURIDGE NURSING AND REHAB LLC
- Doing business as
- BEAUTIFUL SAVIOR HOME
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Apr 26, 2004
- Last certification
- Dec 13, 2024
- Beds
- 126
- Ownership / control type
- Limited Liability Corporation
- Multi-facility organization
- MALIK CORPORATION
- Most recent change of ownership
- Aug 30, 2024
- Organization structure
- LLC · Proprietary
- Enrollment address
- 1003 S Cedar St
Belton, MO 64012-3703 - Nursing home name
- BEAUTIFUL SAVIOR HOME
- Affiliated entity
- SHAFIQ MALIK
All disclosed owners & managing parties 6
| Name | Role | Since | Share |
|---|---|---|---|
| Omer Malik |
5% Or Greater Direct Ownership Interest |
Aug 30, 2024 | 50% |
| Operational/Managerial Control | Dec 18, 2024 | ||
| Adp of the SNF | Dec 18, 2024 | ||
| Forvis Mazars LLP |
Operational/Managerial Control | Aug 30, 2024 | |
| Adp of the SNF | Aug 30, 2024 | ||
| Jennifer Smith |
Operational/Managerial Control | Aug 30, 2024 | |
| Adp of the SNF | Aug 30, 2024 | ||
| Brian Haas |
Corporate Director |
Aug 30, 2024 | |
| Adp of the SNF | Apr 2, 2025 | ||
| Shafiq Malik |
5% Or Greater Direct Ownership Interest |
Aug 30, 2024 | 50% |
| Operational/Managerial Control | Aug 30, 2024 | ||
| Adp of the SNF | Aug 30, 2024 | ||
| Bleauridge Nursing and Rehab LLC |
5% Or Greater Direct Ownership Interest | Aug 30, 2024 | |
| Operational/Managerial Control | Aug 30, 2024 | ||
| Adp of the SNF | Aug 30, 2024 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20241104002199 | MO | Part a Provider - Skilled Nursing Facility | 9537692165 | Practice locations: Belton, MO |
National Provider Directory
- Tax ID family
- Bleauridge Nursing and Rehab LLC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Yes |
Addresses
Primary practice location
1003 Cedar St
Belton, MO 64012
Mailing address
2215 Broadway St
Cape Girardeau, MO 63701-4403
Phone (573) 335-3044
Other names
- Beautiful Savior Nursing Home
Other providers in Belton, MO
- Belton School District
- Belton Senior Living Operator, LLC
- Shannon Berry
- Timothy L Blackburn
- Frank B Blacknall
- Bleauridge Nursing and Rehab LLC
- Kent A Bogner
- Lori Bohnenstiehl
- William Xander Bolden
- Bone & Joint Specialists Physician Group, LLC
All providers in Belton, MO · Skilled Nursing Facility in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 23, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.