Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mission Lake Convalescent Center Inc

Organization Skilled Nursing Facility · NPI 1770528986

Mission Lake Convalescent Center Inc is a Skilled Nursing Facility in Kansas City, Missouri. Licensed in Missouri. Registered with an NPI since 2006.

Licensed in
MO
In the registry since
2006
Specialties on file
3
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

12110 Holmes Rd
Kansas City, MO 64145-1707
Phone: (816) 941-3006
Fax: (816) 942-8049
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Skilled Nursing Facility (primary) Taxonomy 314000000X · Licence 034738 (MO)
Nursing Facility Supplies (DME) Taxonomy 332BN1400X · Licence 032111 (MO)
Parenteral & Enteral Nutrition Supplies (DME) Taxonomy 332BP3500X · Licence 032111 (MO)

Record details

NPI number1770528986
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Loren Rea — President · (816) 941-3006
Other names Timberlake Care Center
NPI enumeratedJune 19, 2006
Last updated in NPPESFebruary 19, 2013
Mailing address12110 Holmes Rd, Kansas City, MO 64145-1707

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