NPIMap

Organization Active NPI

Cassville Health Care Center, L.L.C.

Doing business as Cassville Health Care Center

  • Skilled Nursing Facility
  • Cassville, MO
National Provider Identifier
1508759853
Registry record updated Jun 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
CASSVILLE HEALTH CARE CENTER, L.L.C.
Doing business as
Cassville Health Care Center
Practice address
1300 County Farm Rd
Cassville, MO 65625-1726
Phone
(417) 847-3386
NPI assigned
Jun 3, 2025
Last updated
Jun 3, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 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) 543-3816

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

1300 County Farm Rd
Cassville, MO 65625-1726

Mailing address

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

Other names 1

  • Cassville 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
O20250804001450 MO Part A Provider - Skilled Nursing Facility 9133637952 Practice locations: Cassville, MO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1508759853. Details of each certification follow.

Skilled nursing facility certification: CCN 265460

Legal name
CASSVILLE HEALTH CARE CENTER, L.L.C.
Doing business as
CASSVILLE HEALTH CARE CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Aug 1, 1991
Last certification
Oct 1, 2024
Beds
60
Ownership / control type
Limited Liability Corporation
Most recent change of ownership
Jul 1, 2025
Organization structure
LLCProprietary
Enrollment address
1300 County Farm Rd
Cassville, MO 65625-1726
Nursing home name
CASSVILLE HEALTH CARE CENTER
Affiliated entity
RELIANT CARE MANAGEMENT

Care Compare: Nursing home

Medicare Care Compare
Listed as
Cassville Health Care CenterCCN 265460 · All quality measures
Overall star rating
1 of 5
Health inspections
1 of 5
Staffing
1 of 5
Quality measures
1 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Aug 1, 1991
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
6037.7 residents per day on average
Chain
Reliant Care Management34 facilities in the chain
Special focus status
SFF Candidate
Penalties (3 years)
2Fines totaling $123,925

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 8

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 Jul 1, 2025 0.01%
Richard J. Destefane Revocable Living Trust Organization, Saint Louis, MO Indirect Ownership Interest Jul 1, 2025 100%
Richard J Destefane Individual Corporate OfficerPresident Jul 1, 2025 100%
Operational/Managerial Control Jul 1, 2025
Indirect Ownership Interest Jul 1, 2025 100%
Reliant Care Group LLC Organization, Saint Louis, MO LLC, Holding company, Owned by another organization or individual Direct Ownership Interest Jul 1, 2025 100%
Reliant Care Management Company LLC Organization, Saint Louis, MO LLC, Management services company, Chain home office Operational/Managerial Control Jul 1, 2025
Adp of the SNF Jul 22, 2025
Abdullah Arshad Individual Operational/Managerial Control Jul 1, 2025
Adp of the SNF Jul 1, 2025
Robert Brim Individual Operational/Managerial Control Jul 1, 2025
Adp of the SNF Jul 1, 2025
1300 County Farm Road, L.L.C. Organization, South Bend, IN LLC Adp of the SNF Jul 1, 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 32

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

View all 32

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.

NPI Registry JSON

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

{
    "created_epoch": "1748908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748908800000",
    "number": "1508759853",
    "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": "1300 COUNTY FARM RD",
            "city": "CASSVILLE",
            "state": "MO",
            "postal_code": "656251726",
            "telephone_number": "417-847-3386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CASSVILLE HEALTH CARE CENTER, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-03",
        "last_updated": "2025-06-03",
        "certification_date": "2025-06-03",
        "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": "314-543-3816"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cassville Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cassville, MO

Sources for this page

Verify at the official NPI Registry.