BETHESDA LONG TERM CARE, INC. (NPI# 1073673828) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073673828 |
| Entity Type | Organization |
| Organization Name | BETHESDA LONG TERM CARE, INC. |
| Other Organization Name | THE CHARLESS HOME |
| Practice Address |
4431 South Broadway St. Louis MO 63111 |
| Practice Telephone | 3144814840 |
| Practice Fax Number | 3144811014 |
| Mailing Telephone | 3144814840 |
| Mailing Fax Number | 3144811014 |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2012-01-24 |
| Authorized Official Name | MR. JOSEPH J BRINKER (EXECUTIVE VICE PRESIDENT) |
| Authorized Official Telephone | 3148001986 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 311Z00000X | Custodial Care Facility | Nursing & Custodial Care Facilities | ||
| Y | 314000000X | Skilled Nursing Facility | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| The Charless Home | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922074111 | Bethesda Long Term Care, Inc. | Skilled Nursing Facility | 322 Old State Rd, Ellisville, MO 63021-5917 | 2006-02-27 |
| 1750357950 | Bethesda Long Term Care, Inc. | Skilled Nursing Facility | 5943 Telegraph Rd, Saint Louis, MO 63129-4715 | 2006-02-27 |
| 1497721880 | Bethesda Long Term Care, Inc. | Skilled Nursing Facility | 9645 Big Bend Blvd, Saint Louis, MO 63122-6521 | 2006-02-24 |
| Street Address |
4431 SOUTH BROADWAY |
| City | ST. LOUIS |
| State | MO |
| Zip Code | 63111 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992291660 | Ebony Cannon | Behavior Technician | 7700 Minosotta Ave, St.louis, MO 63111 | 2018-07-06 |
| 1811310212 | Danny Brown | Home Health | 5328 Virginia, Saint Louis, MO 63111 | 2014-01-22 |
| 1548387681 | Raymond Joseph Skosky | Dentist | 5530 Virginia Avenue, Saint Louis, MO 63111 | 2007-03-23 |
| 1972666782 | Diane P Hamill | Optometrist | 1012 Loughborough Commons, St. Louis, MO 63111 | 2006-12-19 |
| 1669542668 | Anna D Naumovich | Internal Medicine | 5205 South Grand Ave, St Louis, MO 63111 | 2006-11-08 |
| 1417040114 | Tony Thien Tang | Internal Medicine | 4675 South Grand Blvd., St. Louis, MO 63111 | 2006-10-02 |
| 1790736171 | Robert Clarence Egan | Surgery | 3535 South Jefferson Ste 101, Ste 101, St Louis, MO 63111 | 2006-05-12 |
| 1790340438 | Marco Samuel Garcia | Student in an Organized Health Care Education/Training Program | 401 Holly Hills Ave, Saint Louis, MO 63111 | 2019-05-08 |
| 1154717593 | Nucrown, LLC | Optometrist | 1012 Loughborough Commons, Saint Louis, MO 63111 | 2015-04-13 |
| 1467871137 | Theresa Drallmeier | Family Medicine | 401 Holly Hills Ave, Saint Louis, MO 63111 | 2014-04-10 |
| Find all providers in zip 63111 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346473873 | Genesis Rehab. | Skilled Nursing Facility | 12858 Strathearn Drive, St. Louis, MO 63146 | 2009-09-01 |
| 1376175679 | Estates of Hidden Lake LLC | Skilled Nursing Facility | 11728 Hidden Lake Dr, St. Louis, MO 63138 | 2020-02-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609492719 | Ignite Medical Resort Independence LLC | Skilled Nursing Facility | 20511 E. Trinity Pl., Blue Springs, MO 64015 | 2020-06-24 |
| 1760006308 | Sunterra Dardenne Prairie Oc LLC | Skilled Nursing Facility | 7275 Highway N, Dardenne Prairie, MO 63368-7126 | 2020-05-29 |
| 1184247215 | Berry Medical Properties, LLC | Skilled Nursing Facility | 11380 Natural Bridge Rd, Bridgeton, MO 63044-2307 | 2020-05-23 |
| 1881249464 | Rolla Grand LLC | Skilled Nursing Facility | 1800 White Columns Dr, Rolla, MO 65401-2044 | 2019-08-09 |
| 1184276982 | Willow Health Care Inc | Skilled Nursing Facility | 712 Copper Rock Dr, Rogersville, MO 65742-8970 | 2019-07-11 |
| 1548734627 | Medicore Medical Service LLC | Skilled Nursing Facility | 2303 Kratky Rd Apt B, Saint Louis, MO 63114-1783 | 2019-01-11 |
| 1518436724 | Missouri Nursing & Rehab LLC | Skilled Nursing Facility | 783 Weber Road, Farmington, MO 63640-3318 | 2018-11-16 |
| 1982172342 | Arrowhead Retirement Operations LLC | Skilled Nursing Facility | 6100 Arrowhead Drive, Osage Beach, MO 65065 | 2018-11-05 |
| 1578039467 | Laverna Senior Living LLC | Skilled Nursing Facility | 904 S Hall Ave, Savannah, MO 64485-1952 | 2018-10-17 |
| 1093297152 | Community Care Center of Union Inc | Skilled Nursing Facility | 1080 Marie Lane, Union, MO 63084 | 2018-09-05 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.