LICKING PARK MANOR
NPI 1609996222
Skilled Nursing Facility in Licking, MO
About Licking Park Manor NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
LICKING PARK MANOR (NPI 1609996222) is a healthcare organization registered as a skilled nursing facility in Licking, Missouri and active in the NPI registry since March 2007. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists James J Giardina, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Other Identifiers 1
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 26D0652411
Licking No 1 Dba Hickory Manor · Licking, MOOther Providers at the Same Location NPPES 2
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Community Care Center Of Licking Inc's NPI number?
The NPI number for Community Care Center Of Licking Inc is 1609996222. It was assigned to this organization in the NPPES registry on March 29, 2007. The provider is doing business as Licking Park Manor.
Where is Community Care Center Of Licking Inc located?
Community Care Center Of Licking Inc is located at 209 Hickory St, Licking, MO 65542. The listed phone number is (573) 674-2111.
What is Community Care Center Of Licking Inc's specialty?
The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.
Does Community Care Center Of Licking Inc hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 26D0652411) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Community Care Center Of Licking Inc was last updated on January 10, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.