Bletel Residential Homes

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

BLETEL RESIDENTIAL HOMES

Practice address

18844 Ladera LN
Waynesville, MO 65583

Phone

(573) 774-5348

Fax

(573) 774-8548

NPI assigned

Jul 19, 2011

Organization subpart

No

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

Authorized official

Name

Lawrence Bleboo

Title

Executive Director

Phone

(573) 855-4652

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1311033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311033600000",
    "number": "1629366182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 507",
            "city": "WAYNESVILLE",
            "state": "MO",
            "postal_code": "65583",
            "telephone_number": "573-774-6166",
            "fax_number": "573-774-8548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18844 LADERA LN",
            "city": "WAYNESVILLE",
            "state": "MO",
            "postal_code": "65583",
            "telephone_number": "573-774-5348",
            "fax_number": "573-774-8548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLETEL RESIDENTIAL HOMES",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-19",
        "last_updated": "2011-07-19",
        "status": "A",
        "authorized_official_last_name": "BLEBOO",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "573-855-4652"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Waynesville, MO
• Providers in Waynesville, MO by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2011; 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.