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 only one registered license in Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded, which is considered as 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
Fax: (314) 340-6199
Website:
Authorized official contact:
Name: Boeckmann, Molly Jane

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded 315P00000X EXEMPT Missouri

Profile Details

NPI number 1760553101
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 Nov 9th, 2006
Last updated Oct 20th, 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 1760553101 NPPES
Missouri MEDICAID 051500106

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