Country Club Care Center of Warrensburg, L.C.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

035593 Issued in MO

Legal business name

COUNTRY CLUB CARE CENTER OF WARRENSBURG, L.C.

Doing business as

Country Club Care Center of Warrensburg

Practice address

503 Regent Dr
Warrensburg, MO 64093-3231

Phone

(660) 429-4444

Fax

(660) 429-4331

NPI assigned

Oct 4, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Steve Bunch

Title

Vice President of Operations

Phone

(660) 429-4444

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Country Club Care Center of Warrensburg Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1128384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321488000000",
    "number": "1013904069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "503 REGENT DR",
            "city": "WARRENSBURG",
            "state": "MO",
            "postal_code": "640933231",
            "telephone_number": "660-429-4444",
            "fax_number": "660-429-4331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 REGENT DR",
            "city": "WARRENSBURG",
            "state": "MO",
            "postal_code": "640933231",
            "telephone_number": "660-429-4444",
            "fax_number": "660-429-4331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTRY CLUB CARE CENTER OF WARRENSBURG, L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-04",
        "last_updated": "2011-11-17",
        "status": "A",
        "authorized_official_last_name": "BUNCH",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "VICE PRESIDENT OF OPERATIONS",
        "authorized_official_telephone_number": "660-429-4444",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MO",
            "license": "035593",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "108240805",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Country Club Care Center of Warrensburg",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Bryon E Conrad, RPH
• Kayla Conrad
• Stephen A Cook, O.D
• Counseling & Psychological Services, University of Central Missouri
• Country Club Care Center of Warrensburg L C (Country Club Care Center)
• Country Club Operator LLC (Country Club Rehab and Healthcare Center)
• Cowart Enterprises (Senior And Disabled Services)
• Hannah Maxine Cox, RBT
• Kylie Crabtree
• Linda Craven

• Skilled Nursing Facility in Warrensburg, MO
• Providers in Warrensburg, MO by specialty
• Skilled Nursing Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.