NPIMap

Organization Active NPI

Sarcoxie Health Care Center, L.L.C.

Doing business as Sarcoxie Health Care Center

  • Skilled Nursing Facility
  • Sarcoxie, MO
National Provider Identifier
1336958982
Registry record updated Jan 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
SARCOXIE HEALTH CARE CENTER, L.L.C.
Doing business as
Sarcoxie Health Care Center
Practice address
1505 Miner St
Sarcoxie, MO 64862-9211
Phone
(417) 548-3434
Fax
(417) 548-6929
NPI assigned
Jan 7, 2025
Last updated
Jan 7, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2025

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

Authorized official

Name
Richard J. Destefane
Title
President
Phone
(314) 422-7910

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NU Primary

Addresses

Primary practice location

1505 Miner St
Sarcoxie, MO 64862-9211

Mailing address

1869 Craig Park CT
Saint Louis, MO 63146-4122
Phone (314) 543-3816

Other names 1

  • Sarcoxie Health Care Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250321000903 MO Part A Provider - Skilled Nursing Facility 4183146970 Practice locations: Sarcoxie, MO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1336958982. Details of each certification follow.

Skilled nursing facility certification: CCN 265649

Legal name
SARCOXIE HEALTH CARE CENTER LLC
Doing business as
SARCOXIE HEALTH CARE CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jun 1, 1996
Last certification
Mar 28, 2025
Beds
40
Ownership / control type
Corporation
Multi-facility organization
RELIANT CARE MANAGEMENT COMPANY LLC
Most recent change of ownership
Jan 25, 2025
Organization structure
LLCProprietary
Enrollment address
1505 Miner St
Sarcoxie, MO 64862-9211
Nursing home name
SARCOXIE HEALTH CARE CENTER
Affiliated entity
RELIANT CARE MANAGEMENT

Care Compare: Nursing home

Medicare Care Compare
Listed as
Sarcoxie Health Care CenterCCN 265649 · All quality measures
Overall star rating
1 of 5
Health inspections
2 of 5
Staffing
1 of 5
Quality measures
1 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Jun 1, 1996
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
4037.4 residents per day on average
Chain
Reliant Care Management34 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
RCG Inc Organization, Saint Louis, MO Corporation, Holding company, Owned by another organization or individual Indirect Ownership Interest Jan 25, 2025 0.01%
Richard J. Destefane Revocable Living Trust Organization, Saint Louis, MO 5% Or Greater Indirect Ownership Interest Jan 25, 2025 100%
Adp of the SNF Jan 25, 2025
Indirect Ownership Interest Jan 25, 2025 100%
Richard J Destefane Individual 5% Or Greater Indirect Ownership InterestPresident Jan 25, 2025 100%
Corporate OfficerPresident Jan 25, 2025 100%
Adp of the SNF Jan 25, 2025
Indirect Ownership Interest Jan 25, 2025 100%
Reliant Care Group LLC Organization, Saint Louis, MO LLC, Holding company, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Jan 25, 2025 100%
Direct Ownership Interest Jan 25, 2025 100%
TLG II LLP Organization, Saint Louis, MO Holding company Adp of the SNF Jan 25, 2025
Reliant Care Management Company LLC Organization, Saint Louis, MO LLC, Management services company, Chain home office Operational/Managerial Control Jan 25, 2025
Adp of the SNF Feb 3, 2025
Abdullah Arshad Individual Operational/Managerial Control Jan 25, 2025
Adp of the SNF Jan 25, 2025
Sarcoxie Associates LLC Organization, Saint Louis, MO LLC Adp of the SNF Jan 25, 2025
Johnna Greathouse Individual Operational/Managerial Control Jan 25, 2025
Adp of the SNF Jan 25, 2025

Owners & managing parties with NPI records 1

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

Facilities with the same owner 33

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

View all 33

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 1

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

NPI Registry JSON

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

{
    "created_epoch": "1736208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736208000000",
    "number": "1336958982",
    "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": "314-543-3816",
            "fax_number": "314-226-1736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 MINER ST",
            "city": "SARCOXIE",
            "state": "MO",
            "postal_code": "648629211",
            "telephone_number": "417-548-3434",
            "fax_number": "417-548-6929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SARCOXIE HEALTH CARE CENTER, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-07",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A",
        "authorized_official_last_name": "DESTEFANE",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "314-422-7910"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sarcoxie Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sarcoxie, MO

Sources for this page

Verify at the official NPI Registry.