Rest Haven SNF Opco LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

REST HAVEN SNF OPCO LLC

Practice address

1800 S Ingram Ave
Sedalia, MO 65301-7538

Phone

(660) 827-0845

Fax

(660) 826-5007

NPI assigned

Jun 22, 2026

Organization subpart

No

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

Authorized official

Name

Nicholas Destefane

Title

President

Phone

(314) 543-3800

Specialties & licenses 1

Addresses

Other names 1

• Rest Haven Health Care Center Doing business as

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

{
    "created_epoch": "1782086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782086400000",
    "number": "1538095054",
    "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": "1800 S INGRAM AVE",
            "city": "SEDALIA",
            "state": "MO",
            "postal_code": "653017538",
            "telephone_number": "660-827-0845",
            "fax_number": "660-826-5007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REST HAVEN 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": "Rest Haven Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Regional Health Care Clinic, Inc
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• Roger Allen Reid
• Rest Haven Health Care Center, L.L.C.
• Blaire Riley, LCSW
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• Roark I.S.L.
• Roark Isl
• Linda K Roark

• All providers in Sedalia, 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.