MEDICARE: CARE CENTER CONSULTANTS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility

General Provider Information

NPI Number	:	1396331575
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARE CENTER CONSULTANTS LLC

Provider Business Mailing Address
First Line	:	601 W 57TH TER
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64113-1168
Country	:	US
Telephone Number	:	863-259-9800
Fax Number	:

Provider Business Practice Location Address
First Line	:	12110 HOLMES RD
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64145-1707
Country	:	US
Telephone Number	:	816-941-3006
Fax Number	:

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	JUDITH REA
Credential	:
Telephone Number	:	816-210-7730

Provider Enumeration Date	:	12/12/2020
Last Update Date	:	02/16/2021

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