Healthcare Provider Details

I. General information

NPI: 1013784198
Provider Name (Legal Business Name): RCAL MANAGEMENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/07/2023
Last Update Date: 01/26/2026
Certification Date: 01/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4904 E WELLRIDGE LN
JOPLIN MO
64801-8706
US

IV. Provider business mailing address

4904 E WELLRIDGE LN
JOPLIN MO
64801-8706
US

V. Phone/Fax

Practice location:
  • Phone: 417-629-4021
  • Fax: 417-623-8900
Mailing address:
  • Phone: 417-629-4021
  • Fax: 417-623-8900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. MICHAEL KEVIN MATHENY II
Title or Position: OWNER / MANAGER
Credential: R.N.
Phone: 417-629-4021