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Mission Lake Convalescent Center Inc.

Skilled Nursing Facility in Kansas City, MO · enumerated 2006 · authorized official Loren Rea, President.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1770528986

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Registry record

Entity type Organization (Type 2)
Legal business name Mission Lake Convalescent Center Inc.
Other name <Unavail>
Practice address 12110 Holmes Rd, Kansas City, MO, 64145
Phone (816) 941-3006
Fax (816) 942-8049
Enumeration date Jun 19, 2006
Last updated in NPPES Feb 19, 2013

Taxonomy & classification

314000000X Skilled Nursing Facility Nursing & Custodial Care Facilities · License 034738 (MO) Primary
332BN1400X Nursing Facility Supplies (DME) Suppliers · License 032111 (MO) Secondary
332BP3500X Parenteral & Enteral Nutrition Supplies (DME) Suppliers · License 032111 (MO) Secondary

Authorized official

Name Loren Rea
Title President
Phone (816) 941-3006

Other identifiers

Identifier Type State Issuer
032111 Other MO PROVIDER
1770528986 Other MO NPI
102084506 Medicaid MO -

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

Where is Mission Lake Convalescent Center Inc. located?
The practice location on file with NPPES is in Kansas City, MO.
How current is this record?
Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2013-02-19. Verify at npiregistry.cms.hhs.gov.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2013-02-19.