Organization
BOONVILLE NO2 INC
Active
Other names
Riverdell Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DONALD B BEDELL (PRESIDENT)
(573) 471-1276
Entity
Organization
Contact information
Practice address
1121 11TH ST, BOONVILLE, MO 65233-1419
(660) 882-7600
(660) 882-3473
Mailing address
PO BOX 1210, SIKESTON, MO 63801-1210
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
044927
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102529401
—
MO
Enumeration date
07/07/2006
Last updated
10/26/2021
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