Edgewood Manor Health Care Center, L.L.C.
NPI 1467072280ActiveOrganization· Skilled Nursing Facility· Raytown, MO
Skilled Nursing Facility in Raytown, Missouri, registered in NPPES in April 2020. The authorized official on file is Richard J. Destefane, President. Enrolled in Medicare as part a provider - skilled nursing facility.
Overview
| NPI | 1467072280 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Apr 22, 2020 |
| Last updated in NPPES | Apr 22, 2020 |
| Certified by provider | Apr 22, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Skilled Nursing Facility Primary | 314000000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part A Provider - Skilled Nursing Facility (MO) |
|---|
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