Organization
BOONVILLE NO 1 INC
Active
Other names
Lakeview Health Care & Rehabilitation Center
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD B BEDELL (PRESIDENT)
(573) 471-1276
Entity
Organization
Contact information
Practice address
1450 W ASHLEY RD, BOONVILLE, MO 65233
(660) 882-7007
Mailing address
PO BOX 1210, SIKESTON, MO 63801-1210
(573) 471-1276
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
046405
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101777001
—
MO
Enumeration date
07/07/2006
Last updated
06/19/2018
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