Cedargate Opco LLC

Skilled Nursing Facility · Poplar Bluff, MO

Organization Active NPI

NPI number 1053247627

Practice location

2350 Kanell Blvd
Poplar Bluff, MO 63901-4036
Phone
(573) 785-0188
Fax
(573) 785-7321

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NPI record

NPI
1053247627
Entity type
Organization (Type 2)
Enumeration date
June 22, 2026
Last updated
June 22, 2026
Certified
June 22, 2026
Organization subpart
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Skilled Nursing Facility Primary 314000000X — —

Mailing address

1869 Craig Park Ct
Saint Louis, MO 63146-4122
Phone
(314) 543-3800
Fax
(314) 543-3800

Authorized official

Name
Nicholas Destefane
Title
President
Phone
(314) 543-3800

Other names

  • Cedargate Health Care Center

About Cedargate Opco LLC

Cedargate Opco LLC is a healthcare organization registered in the NPI registry with the primary taxonomy Skilled Nursing Facility (code 314000000X). The practice location is 2350 Kanell Blvd, Poplar Bluff, MO 63901-4036. The NPI number 1053247627 was assigned on June 22, 2026 and the record was last updated on June 22, 2026.

The authorized official for this organization is Nicholas Destefane, President.

Frequently asked questions

What is the NPI number of Cedargate Opco LLC?

The NPI number is 1053247627.

What is the phone number of Cedargate Opco LLC?

The phone number listed for the practice location is (573) 785-0188.

Where is Cedargate Opco LLC located?

2350 Kanell Blvd, Poplar Bluff, MO 63901-4036.

What is the taxonomy code for Cedargate Opco LLC?

The primary taxonomy code is 314000000X – Skilled Nursing Facility.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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