Bellefontaine Gardens Nursing & Rehab, Inc.

Organization Active NPI Skilled Nursing Facility · Saint Louis, MO

NPI 1710973136 · NPPES record last updated Nov 3, 2011

Key facts

NPI
1710973136
Entity type
Organization (NPI type 2)
Primary specialty
Skilled Nursing Facility 314000000X
License
030826 (MO)
Legal business name
BELLEFONTAINE GARDENS NURSING & REHAB, INC.
Practice address
9500 Bellefontaine Rd
Saint Louis, MO 63137-1336
Phone
(314) 388-0796
Fax
(314) 388-2654
NPI assigned
Sep 21, 2005
Organization subpart
No

Authorized official

Name
Mr. James C Lincoln
Title
Shareholder
Phone
(573) 746-7100

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 030826 MO Yes

Addresses

Primary practice location

9500 Bellefontaine Rd
Saint Louis, MO 63137-1336

Mailing address

9500 Bellefontaine Rd
Saint Louis, MO 63137-1336
Phone (314) 388-0796

Other identifiers

IdentifierTypeStateIssuer
17401305OtherMOSTATE ID
102972700MedicaidMO

Other names

  • Bellefontaine Gardens Nursing & Rehab Doing business as

Other providers in Saint Louis, MO

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

Sources for this page

Verify at the official NPI Registry.