Healthcare Provider Details

I. General information

NPI: 1679520258
Provider Name (Legal Business Name): MIDWEST DIVISION - LRHC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2006
Last Update Date: 11/10/2025
Certification Date: 11/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 STATE ST
LEXINGTON MO
64067-1107
US

IV. Provider business mailing address

1500 STATE ST
LEXINGTON MO
64067-1107
US

V. Phone/Fax

Practice location:
  • Phone: 660-259-2203
  • Fax: 660-259-6819
Mailing address:
  • Phone: 660-259-2203
  • Fax: 660-259-6819

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number
License Number State

VIII. Authorized Official

Name: TERI JAMES
Title or Position: CFO
Credential:
Phone: 660-259-6893