| Blue Castle Bolivar Llc | |
|
1830 E Laverne St Bolivar MO 65613-1488 | |
| (417) 777-2583 | |
| (417) 326-2584 |
| Full Name | Blue Castle Bolivar Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1830 E Laverne St, Bolivar, Missouri |
| Authorized Official Name and Position | Naiya Patel (OWNER/MANAGER) |
| Authorized Official Contact | 9137448430 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Blue Castle Bolivar Llc 1830 E Laverne St Bolivar MO 65613-1488 Ph: (417) 777-2583 | Blue Castle Bolivar Llc 1830 E Laverne St Bolivar MO 65613-1488 Ph: (417) 777-2583 |
| NPI Number | 1538939723 |
|---|---|
| Provider Enumeration Date | 01/08/2024 |
| Last Update Date | 01/08/2024 |
| Certification Date | 01/08/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538939723 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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