Bravo Care of Wood River Inc

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

BRAVO CARE OF WOOD RIVER INC

Practice address

395 E Edwardsville Rd
Wood River, IL 62095-1600

Phone

(618) 259-0851

NPI assigned

Oct 15, 2007

Organization subpart

No

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

Authorized official

Name

Aleksandra Savic

Title

Ar Director

Phone

(314) 994-9070

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1192406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480550400000",
    "number": "1760670897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11701 BORMAN DR STE 315",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631464194",
            "telephone_number": "314-994-9070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "395 E EDWARDSVILLE RD",
            "city": "WOOD RIVER",
            "state": "IL",
            "postal_code": "620951600",
            "telephone_number": "618-259-0851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAVO CARE OF WOOD RIVER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-15",
        "last_updated": "2016-12-01",
        "status": "A",
        "authorized_official_last_name": "SAVIC",
        "authorized_official_first_name": "ALEKSANDRA",
        "authorized_official_title_or_position": "AR DIRECTOR",
        "authorized_official_telephone_number": "314-994-9070"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katie Lynn Bartels, PHARMD
• Rachael Ann Beard, RN, BSN, M.ED
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• Jared Andrew Blaylock, PHARMD
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• Keith N Byler, D. O.
• Caldieraro Family Dentistry, PC

• All providers in Wood River, IL
• Assisted Living Facility in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2016; 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.