Beauvais Manor Healthcare & Rehab Center

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

035624 Issued in MO

Legal business name

BEAUVAIS MANOR HEALTHCARE & REHAB CENTER

Practice address

3625 Magnolia Ave
Saint Louis, MO 63110-4048

Phone

(314) 771-2990

Fax

(314) 771-7960

NPI assigned

Feb 25, 2008

Organization subpart

No

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

Authorized official

Name

Sheldon Wolfe

Title

Member

Phone

(847) 982-2300

Specialties & licenses 2

Addresses

Other identifiers 1

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

{
    "created_epoch": "1203897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217376000000",
    "number": "1326217217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7434 SKOKIE BLVD",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600773341",
            "telephone_number": "847-982-2300",
            "fax_number": "847-982-2304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3625 MAGNOLIA AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631104048",
            "telephone_number": "314-771-2990",
            "fax_number": "314-771-7960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEAUVAIS MANOR HEALTHCARE & REHAB CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-25",
        "last_updated": "2008-07-30",
        "status": "A",
        "authorized_official_last_name": "WOLFE",
        "authorized_official_first_name": "SHELDON",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "847-982-2300"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MO",
            "license": "035624",
            "primary": true
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MO",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "108680109",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Olivia Beaubrun, MD
• Tatyana Beaubrun, MD
• Jakeia Kiarra Beauford I
• Beautification Concepts LLC
• Beauvais Manor
• Beauvais Operator LLC
• Erin M Beaver, MS CGC
• Heidi Alison Beaver, MPH, CGC
• Christopher Andre Beavers, COTA/L
• Jennifer Rebecca Beavers, MSW, LCSW

• All providers in Saint Louis, MO
• Skilled Nursing Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2008; 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.