Timberlake Care Center

LBN: Mission Lake Convalescent Center Inc.
Timberlake Care Center is an health care organization with primary practice located at 12110 Holmes Rd , Kansas City MO 64145-1707. The organization recently has 3 registered licenses in different health care specialties including Nursing & Custodial Care Facilities / Skilled Nursing Facility, Suppliers / Nursing Facility Supplies, Suppliers / Parenteral & Enteral Nutrition. Nursing & Custodial Care Facilities / Skilled Nursing Facility is the primary health care specialty. Mission Lake Convalescent Center Inc. can be contacted via phone (816) 941-3006, or through Rea, Loren via phone (816) 941-3006.

Contact Information

Primary practice address
12110 Holmes Rd Kansas City MO 64145-1707
Phone: (816) 941-3006
Fax: (816) 942-8049
Website:
Map and Directions
Authorized official contact:
Name: Rea, Loren
Phone: (816) 941-3006

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Skilled Nursing Facility 314000000X 034738 Missouri
Suppliers / Nursing Facility Supplies 332BN1400X 032111 Missouri
Suppliers / Parenteral & Enteral Nutrition 332BP3500X 032111 Missouri

Profile Details

NPI number 1770528986
LBN Legal business name Mission Lake Convalescent Center Inc.
DBA Doing business as Timberlake Care Center
Authorized official Rea, Loren
Entity Organization
Organization subpart 1 No
Enumeration date Jun 19th, 2006
Last updated Feb 19th, 2013 - about 12 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 1770528986 NPPES
Missouri Other 032111 PROVIDER
Missouri Other 1770528986 PROVIDER
Missouri MEDICAID 102084506 PROVIDER

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