# HMG PARK MANOR OF BELLEVILLE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** BELLEVILLE HEALTH CARE CENTER
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124205901
- **Authorized official:** MR. LAURENCE C. DASPIT (CEO)
- **Authorized official phone:** (281) 419-5520

## Contact information

- **Practice address:** 2626 WESLEYAN DR, BELLEVILLE, KS 66935-2440
- **Practice address phone:** (785) 527-5636
- **Practice address fax:** (785) 527-5419
- **Mailing address:** 1780 HUGHES LANDING BLVD STE 500, THE WOODLANDS, TX 77380-4009
- **Mailing address phone:** (281) 419-5520
- **Mailing address fax:** (281) 419-5527

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | N079001 | KS | Yes |

## Other

- **Enumeration date:** 01/24/2008
- **Last updated:** 11/04/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 200557040B | — | KS |