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Mission Lake Convalescent Center Inc.
Parenteral & Enteral Nutrition Supplies (DME) in Kansas City, Missouri
NPI 1770528986

Mission Lake Convalescent Center Inc. is a Parenteral & Enteral Nutrition Supplies (DME) based in Kansas City, MO and is specialized in Parenteral & Enteral Nutrition. Mission Lake Convalescent Center Inc. practices in Kansas City, MO. The NPI Number for Mission Lake Convalescent Center Inc. is 1770528986 and holds a License No. 034738 (Missouri).

The current practice location address for Mission Lake Convalescent Center Inc. is 12110 Holmes Rd, Kansas City, MO and can be reached out via phone at 816-941-3006 and via fax at 816-942-8049.

Location: 12110 Holmes Rd, Kansas City, MO, 64145-1707
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1770528986
Provider Name
Mission Lake Convalescent Center Inc.
Credential
Provider Entity Type
Organization
Address
12110 Holmes Rd, Kansas City, MO, 64145-1707
Phone Number
816-941-3006
Fax Number
816-942-8049
Provider Enumeration Date
06/19/2006
Last Update Date
03/12/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
032111 01 MO PROVIDER
1770528986 01 MO NPI
102084506 05 MO
institution
Provider Business Practice Location Address Details
Address
12110 Holmes Rd
City
Kansas City
State
Missouri
Zip
64145-1707
Phone Number
816-941-3006
Fax Number
816-942-8049
person
Provider Business Mailing Address Details
Address
12110 Holmes Rd
City
Kansas City
State
Missouri
Zip
64145-1707
Phone Number
816-941-3006
Fax Number
816-942-8049
person
Provider's Taxonomy Details 1
Type
Nursing & Custodial Care Facilities
Classification
Skilled Nursing Facility
Speciality
-
Taxonomy
314000000X
License No.
032111 (Missouri)
Definition
(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.
person
Provider's Taxonomy Details 2
Type
Suppliers
Classification
Durable Medical Equipment & Medical Supplies
Speciality
Nursing Facility Supplies
Taxonomy
332BN1400X
License No.
032111 (Missouri)
Definition
Definition to come...
person
Provider's Taxonomy Details 3
Type
Suppliers
Classification
Durable Medical Equipment & Medical Supplies
Speciality
Parenteral & Enteral Nutrition
Taxonomy
332BP3500X
License No.
034738 (Missouri)
Definition
Definition to come...
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