Bellefontaine Habilitation Center

LBN: State Of Missouri
Bellefontaine Habilitation Center is an health care organization with primary practice located at 10695 Bellefontaine Rd , Saint Louis MO 63137-2315. The organization recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, Allopathic & Osteopathic Physicians / Psychiatry. Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation is the primary health care specialty. State Of Missouri can be contacted via phone (314) 340-6000, or through Boeckmann, Molly Jane via phone (573) 751-4055.

Contact Information

Primary practice address
10695 Bellefontaine Rd Saint Louis MO 63137-2315
Phone: (314) 340-6000
Fax: (314) 340-6199
Website:
Map and Directions
Authorized official contact:
Name: Boeckmann, Molly Jane
Phone: (573) 751-4055

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X

Profile Details

NPI number 1710931167
LBN Legal business name State Of Missouri
DBA Doing business as Bellefontaine Habilitation Center
Authorized official Boeckmann, Molly Jane
Entity Organization
Organization subpart 1 Yes
Enumeration date May 20th, 2006
Last updated Oct 27th, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710931167 NPPES
Missouri MEDICAID 501500102
Missouri Other CG4952

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