Basic Information
Provider Information
NPI: 1326657107
EntityType: 2
ReplacementNPI:  
OrganizationName: HELIA RICHLAND HEALTHCARE LLC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: RICHLAND NURSING & REHAB
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 500 NW PLAZA DR STE 712
Address2:  
City: SAINT ANN
State: MO
PostalCode: 630742222
CountryCode: US
TelephoneNumber: 3143172003
FaxNumber:  
Practice Location
Address1: 900 E SCOTT ST
Address2:  
City: OLNEY
State: IL
PostalCode: 624502576
CountryCode: US
TelephoneNumber: 6183951000
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/28/2020
LastUpdateDate: 06/04/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: MILLS
AuthorizedOfficialFirstName: MICHAEL
AuthorizedOfficialMiddleName: JASON
AuthorizedOfficialTitleorPosition: CFO
AuthorizedOfficialTelephone: 3145660459
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: MR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/04/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
314000000X  Y Nursing & Custodial Care FacilitiesSkilled Nursing Facility 

No ID Information.


Home