BELLEFONTAINE HABILITAION CENTER-WAIVER SERVICES
NPI 1770866030
Intermediate Care Facility, Intellectual Disabilities in Saint Louis, MO

NPI Status: Active since September 23, 2011

Contact Information

10695 BELLEFONTAINE RD
SAINT LOUIS, MO
ZIP 63137
Phone: (314) 340-6000
Fax: (314) 340-6199

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About BELLEFONTAINE HABILITAION CENTER-WAIVER SERVICES

This page provides the complete NPI Profile along with additional information for Bellefontaine Habilitaion Center-waiver Services, a provider established in Saint Louis, Missouri operating as a Intermediate Care Facility, Intellectual Disabilities. The healthcare provider is registered in the NPI registry with number 1770866030 assigned on September 2011. The practitioner's primary taxonomy code is 315P00000X. The provider is registered as an organization and their NPI record was last updated 5 years ago. The provider's is doing business as Bellefontaine Habilitaion Center-waiver Services. The authorized official of this NPI record is Molly Jane Boeckmann (Director Of Administrative Services)

NPI
1770866030
Provider Legal Name
STATE OF MISSOURI
Other Organization Name
BELLEFONTAINE HABILITAION CENTER-WAIVER SERVICES
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
10695 BELLEFONTAINE RD SAINT LOUIS, MO 63137
Location Phone
(314) 340-6000
Location Fax
(314) 340-6199
Mailing Address
1706 E. ELM ST. PO BOX 687 JEFFERSON CITY, MO 65102
Mailing Phone
(573) 751-3398
Mailing Fax
(314) 340-6199
Is Sole Proprietor?
No
Is Organization Subpart?
Yes
Enumeration Date
09-23-2011
Last Update Date
10-27-2020
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Intermediate Care Facility, Intellectual Disabilities

Taxonomy Code
315P00000X
Type
Nursing & Custodial Care Facilities
Taxonomy Description
An intermediate care facility providing services for individuals with intellectual disabilities.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MOLLY JANE BOECKMANN

Authorized Official Title
DIRECTOR OF ADMINISTRATIVE SERVICES
Authorized Official Phone
(573) 751-4055

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1770866030
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
271401661206
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 7 + 1 + 4 + 0 + 1 + 6 + 6 + 1 + 2 + 0 + 6 + 24 = 60
Step 3: because the number obtained in step 2 ends in zero, the check digit is zero.
0

The NPI number 1770866030 is valid because the calculated check digit 0 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 2 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1710931167STATE OF MISSOURI
Organization
Physical Medicine & Rehabilitation10695 BELLEFONTAINE RD
SAINT LOUIS, MO 63137
(314) 340-6000
1760553101STATE OF MISSOURI
Organization
Intermediate Care Facility, Intellectual Disabilities10695 BELLEFONTAINE RD
SAINT LOUIS, MO 63137
(314) 340-6000

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1770866030, enumerated in the NPI registry as an "organization" on September 23, 2011

The provider is located at 10695 Bellefontaine Rd Saint Louis, Mo 63137 and the phone number is (314) 340-6000

This medical organization specializes in Intermediate Care Facility, Intellectual Disabilities with taxonomy code 315P00000X

This NPI record was last updated on September 23, 2011. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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