Healthcare Provider Details

I. General information

NPI: 1093712549
Provider Name (Legal Business Name): LIVING COMMUNITY OF ST. JOSEPH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2005
Last Update Date: 01/22/2026
Certification Date: 01/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1202 HEARTLAND RD
SAINT JOSEPH MO
64506-3200
US

IV. Provider business mailing address

1202 HEARTLAND RD
SAINT JOSEPH MO
64506-3200
US

V. Phone/Fax

Practice location:
  • Phone: 816-671-8500
  • Fax: 816-671-8571
Mailing address:
  • Phone: 816-671-8500
  • Fax: 816-671-8571

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number030176
License Number StateMO

VIII. Authorized Official

Name: MS. AMY BYROM
Title or Position: CEO/ADMINISTRATOR
Credential:
Phone: 816-671-8500