- Enrollment id
- O20211108002156
- Enrollment state
- MO
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1285308031
- Multiple npi flag
- N
- Ccn
- 265699
- Associate id
- 0042609380
- Organization name
- BEAUVAIS OPERATOR LLC
- Doing business as name
- BEAUVAIS REHAB AND HEALTHCARE CENTER
- Incorporation date
- 2021-06-22
- Incorporation state
- MO
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- BEAUVAIS REHAB AND HEALTHCARE CENTER
- Affiliation entity name
- AMA HOLDINGS
- Affiliation entity id
- 27
- Address line 1
- 3625 MAGNOLIA AVENUE
- City
- SAINT LOUIS
- State
- MO
- Zip code
- 631104048