Provider Demographics
NPI:1922094523
Name:BB&K, INC.
Entity Type:Organization
Organization Name:BB&K, INC.
Other - Org Name:BAISCH NURSING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR/C.E.O.
Authorized Official - Prefix:MR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:WARREN
Authorized Official - Last Name:BAISCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:636-586-2291
Mailing Address - Street 1:3260 BAISCH DR
Mailing Address - Street 2:
Mailing Address - City:DE SOTO
Mailing Address - State:MO
Mailing Address - Zip Code:63020-5046
Mailing Address - Country:US
Mailing Address - Phone:636-586-2291
Mailing Address - Fax:636-586-2292
Practice Address - Street 1:3260 BAISCH DR
Practice Address - Street 2:
Practice Address - City:DE SOTO
Practice Address - State:MO
Practice Address - Zip Code:63020-5046
Practice Address - Country:US
Practice Address - Phone:636-586-2291
Practice Address - Fax:636-586-2292
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-20
Last Update Date:2008-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO031516314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO104685003Medicaid
MO265714Medicare Oscar/Certification