Greenville SNF Opco LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

GREENVILLE SNF OPCO LLC

Doing business as

Greenville Health Care Center

Practice address

117 Sycamore St
Greenville, MO 63944-8131

Phone

(573) 224-3298

Fax

(573) 224-5338

NPI assigned

Jun 22, 2026

Last updated

Jun 22, 2026By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Nicholas Destefane

Title

President

Phone

(314) 543-3800

Specialties & licenses 1

Addresses

Other names 1

• Greenville Health Care Center Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1782086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782086400000",
    "number": "1285560771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1869 CRAIG PARK CT",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631464122",
            "telephone_number": "314-543-3800",
            "fax_number": "314-543-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 SYCAMORE ST",
            "city": "GREENVILLE",
            "state": "MO",
            "postal_code": "639448131",
            "telephone_number": "573-224-3298",
            "fax_number": "573-224-5338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENVILLE SNF OPCO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-06-22",
        "last_updated": "2026-06-22",
        "certification_date": "2026-06-22",
        "status": "A",
        "authorized_official_last_name": "DESTEFANE",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "314-543-3800"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Greenville Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• East Wayne County Ambulance District
• Jennifer Lynn Ennis, MCD CCC SLP
• Greenville Health Care Center, L.L.C. (Greenville Health Care Center)
• Greenville Nursing and Rehabilitation, LLC
• Greenville School Dist R 11
• Robert Haldeman Jr., BSN, RN
• Tiffany Eliazbeth Henry
• Jennifer Anne Hovis, FNP
• Norma Kay Lloyd
• Kimberly Michelle Melton

• Skilled Nursing Facility in Greenville, MO
• Providers in Greenville, MO by specialty
• Skilled Nursing Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.