Organization
DELHAVEN MANOR NO 2 INC
Active
Other names
Delhaven Manor
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD B BEDELL (PRESIDENT)
(573) 471-1276
Entity
Organization
Contact information
Practice address
5460 DELMAR BLVD, SAINT LOUIS, MO 63112-3104
(314) 361-2902
Mailing address
PO BOX 1210, SIKESTON, MO 63801-1210
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
044755
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101452605
—
MO
Enumeration date
07/07/2006
Last updated
01/03/2017
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