Basic Information
Provider Information
NPI: 1982855052
EntityType: 2
ReplacementNPI:  
OrganizationName: HELIA SOUTHBELT HEALTHCARE, LLC
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Mailing Information
Address1: 500 NW PLAZA DR STE 712
Address2:  
City: SAINT ANN
State: MO
PostalCode: 630742222
CountryCode: US
TelephoneNumber: 3145660459
FaxNumber:  
Practice Location
Address1: 101 S BELT W
Address2:  
City: BELLEVILLE
State: IL
PostalCode: 622202503
CountryCode: US
TelephoneNumber: 6182777700
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/07/2008
LastUpdateDate: 06/04/2021
NPIDeactivationReasonCode:  
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AuthorizedOfficialLastName: MILLER
AuthorizedOfficialFirstName: STEVEN
AuthorizedOfficialMiddleName: P
AuthorizedOfficialTitleorPosition: PRINCIPAL / OWNER
AuthorizedOfficialTelephone: 3144310511
IsSoleProprietor:  
IsOrganizationSubpart: N
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NPICertificationDate: 06/04/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
314000000X0048587ILY Nursing & Custodial Care FacilitiesSkilled Nursing Facility 

No ID Information.


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