Healthcare Provider Details

I. General information

NPI: 1588652341
Provider Name (Legal Business Name): JOHNSON COUNTY CARE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

122 E MARKET ST
WARRENSBURG MO
64093-1818
US

IV. Provider business mailing address

122 E MARKET ST
WARRENSBURG MO
64093-1818
US

V. Phone/Fax

Practice location:
  • Phone: 660-747-8101
  • Fax: 660-747-9671
Mailing address:
  • Phone: 660-747-8101
  • Fax: 660-747-9671

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number
License Number StateMO

VIII. Authorized Official

Name: RHONDA MEYRAND
Title or Position: ADMINISTRATOR
Credential:
Phone: 660-747-8101