NPIMap

C.M.C. Extended Care Center, Inc.

Organization Active NPI Skilled Nursing Facility · Saint Louis, MO

NPI 1063469765 · NPPES record last updated Jul 13, 2026

Key facts

NPI
1063469765
Entity type
Organization (NPI type 2)
Primary specialty
Skilled Nursing Facility 314000000X
License
31339 (MO)
Legal business name
C.M.C. EXTENDED CARE CENTER, INC.
Practice address
3520 Chouteau Ave
Saint Louis, MO 63103-2916
Phone
(314) 771-2100
Fax
(314) 771-7667
NPI assigned
May 28, 2006
Organization subpart
No

Authorized official

Name
Cindy S Cross
Title
Assistant Secretary
Phone
(423) 473-5867

Owners & managing parties with NPI records 25

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 193

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 193

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

Medicare Care Compare: Nursing home

Listed as
Life Care Center of St Louis CCN 265610
Overall star rating
★★★★☆ 4 of 5
Health inspections
★★★☆☆ 3 of 5
Staffing
★★★☆☆ 3 of 5
Quality measures
★★★★★ 5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Individual
Certified
Apr 6, 1995
Medicare certification status
Active (Provider of Services file)
Certified beds
100 · 91.8 residents per day on average
Chain
Life Care Centers of America (194 facilities)
Penalties (3 years)
1 · fines totaling $15,646

Source: Medicare Care Compare, processed Aug 1, 2026.

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
26D0900202Life Care Center of Saint Louis
3520 Chouteau Avenue, Saint Louis, MO 63103		Certificate of waiverApr 18, 2027

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MO

Skilled nursing facility certification: CCN 265610

Legal name
C.M.C. EXTENDED CARE CENTER, INC.
Doing business as
LIFE CARE CENTER OF SAINT LOUIS
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Apr 6, 1995
Last certification
Apr 23, 2024
Beds
100
Ownership / control type
Individual
Multi-facility organization
CMC Extended Care Inc
Organization structure
Corporation · Proprietary
Incorporated
Mar 4, 1993 in MO
Enrollment address
3520 Chouteau Ave
Saint Louis, MO 63103-2916
Nursing home name
LIFE CARE CENTER OF ST LOUIS
Affiliated entity
LIFE CARE CENTERS OF AMERICA

All disclosed owners & managing parties 6

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Forrest L Preston
Individual 		5% Or Greater Direct Ownership Interest Mar 4, 1993 100%
Corporate Officer
President/Board Member		 Jul 28, 1993
Corporate Director
President/Board Member		 Feb 1, 1994
Operational/Managerial Control Feb 1, 1994
Joanna J Crooks
Individual 		Corporate Officer
VP/Secretary/Treasurer/Board Mem		 Aug 19, 2009
Corporate Director
VP/Secretary/Treasurer/Board Mem		 Aug 19, 2009
Joan E Thurmond
Individual 		Corporate Officer
Assistant Secretary		 Aug 1, 2002
Cindy S Cross
Individual 		Corporate Officer
Assistant Secretary		 Jul 28, 1993
Richard Swanker
Individual 		Corporate Officer
Chief Tax Officer		 Apr 1, 2011
Life Care Centers of America, Inc.
Organization · Cleveland, TN 		Operational/Managerial Control Mar 23, 1995 100%

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20040622000550 MO Part a Provider - Skilled Nursing Facility 4082699269 Practice locations: Saint Louis, MO

National Provider Directory

Locations

3520 Chouteau Ave
Saint Louis, MO 63103
Phone (314) 368-3422

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 31339 MO Yes

Addresses

Primary practice location

3520 Chouteau Ave
Saint Louis, MO 63103-2916

Mailing address

3001 Keith St NW
Cleveland, TN 37312-3713
Phone (423) 473-5751

Other identifiers

IdentifierTypeStateIssuer
107898900MedicaidMO

Other names

  • Life Care Center of St. Louis Doing business as

Electronic endpoints

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Ability Network

Other providers in Saint Louis, MO

All providers in Saint Louis, MO · Skilled Nursing Facility in Missouri

Sources for this page

Verify at the official NPI Registry.