Blu Fountain Manor

LBN: Beverly Enterprises - Illinois, Inc.
Blu Fountain Manor is an health care organization with primary practice located at 1623 W. Delmar #29, Godfrey IL 62035. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Skilled Nursing Facility, which is considered as the primary health care specialty. Beverly Enterprises - Illinois, Inc. can be contacted via phone (618) 466-0443, or through Merrell, David via phone (479) 201-4840.

Contact Information

Primary practice address
1623 W. Delmar #29 Godfrey IL 62035
Phone: (618) 466-0443
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Merrell, David
Phone: (479) 201-4840

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Skilled Nursing Facility 314000000X

Profile Details

NPI number 1699868257
LBN Legal business name Beverly Enterprises - Illinois, Inc.
DBA Doing business as Blu Fountain Manor
Authorized official Merrell, David
Entity Organization
Organization subpart 1 No
Enumeration date Oct 2nd, 2006
Last updated Aug 22nd, 2020 - about 6 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1699868257 NPPES
Illinois Other 53511 GROUP HP
Illinois Other 105286 GROUP HP

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