Organization · Type 2 NPI

Cedargate Health Care Center, LLC

Skilled Nursing Facility · Poplar Bluff, MO

NPI number 1922998988 Active

Practice location

2350 Kanell Blvd
Poplar Bluff, MO 63901-4036

Call (573) 785-0188 Map

Mailing address

1869 Craig Park Ct
St. Louis, MO 63146-4122

Specialties and licenses

Taxonomy	Code	License
Alzheimer Center (Dementia Center)	311500000X	None listed
Skilled Nursing Facility Primary	314000000X	None listed

Skilled Nursing Facility: (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to r…

8 other providers at this address

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NPI record

NPI: 1922998988
Entity type: Organization (Type 2)
Issued: Jul 9, 2025
Last updated: Nov 24, 2025
Status: Active

Other names

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Cedargate Health Care Center · doing business as
Cedargate Health Care Center · doing business as

Authorized official

Richard J. Destefane
President
(314) 543-3816

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1922998988

Cedargate Health Care Center, LLC's National Provider Identifier is 1922998988, issued on Jul 9, 2025. The primary taxonomy on file is Skilled Nursing Facility (314000000X), and the practice location is in Poplar Bluff, MO. The record was last updated on Nov 24, 2025.