Odessa SNF Opco LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

ODESSA SNF OPCO LLC

Practice address

609 Golf St
Odessa, MO 64076-1462

Phone

(816) 230-7530

Fax

(816) 633-7661

NPI assigned

Jun 22, 2026

Organization subpart

No

Name

Nicholas Destefane

Title

President

Phone

(314) 543-3800

• Odessa Health Care Center Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 22, 2026.

{
    "created_epoch": "1782086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782086400000",
    "number": "1326974841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1869 CRAIG PARK CT",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631464122",
            "telephone_number": "314-543-3800",
            "fax_number": "314-543-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 GOLF ST",
            "city": "ODESSA",
            "state": "MO",
            "postal_code": "640761462",
            "telephone_number": "816-230-7530",
            "fax_number": "816-633-7661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ODESSA SNF OPCO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-06-22",
        "last_updated": "2026-06-22",
        "certification_date": "2026-06-22",
        "status": "A",
        "authorized_official_last_name": "DESTEFANE",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "314-543-3800"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Odessa Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Odessa Family Pharmacy
• Odessa Fire & Rescue Protection District
• Odessa Health Care Center, L.L.C.
• Odessa Medical Clinic, PC
• Odessa Pediatric Dental Care
• Emmaline Owen
• Carrie Parrish, COTA
• Linda Lou Proctor, R.N.
• Kayla Jo Rains, LCSW
• Judith L. Raugewitz, COTA/L

• All providers in Odessa, MO
• Skilled Nursing Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2026; 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.