Healthcare Provider Details

I. General information

NPI: 1972694271
Provider Name (Legal Business Name): RAYMORE CARE CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 E SUNRISE DR
RAYMORE MO
64083-9037
US

IV. Provider business mailing address

600 E SUNRISE DR
RAYMORE MO
64083-9037
US

V. Phone/Fax

Practice location:
  • Phone: 816-322-1991
  • Fax: 816-322-4810
Mailing address:
  • Phone: 816-322-1991
  • Fax: 816-322-4810

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number032153
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number031724
License Number StateMO

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier90462017
Identifier TypeOTHER
Identifier StateMO
Identifier IssuerBC/BS PROVIDER NUMBER

VIII. Authorized Official

Name: MR. MELVIN L DUNSWORTH
Title or Position: OWNER/PRESIDENT
Credential:
Phone: 816-322-1991