Cedargate Al Opco LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

CEDARGATE AL OPCO LLC

Practice address

2350 Kanell Blvd
Poplar Bluff, MO 63901-4036

Phone

(573) 785-0188

Fax

(573) 785-7321

NPI assigned

Jun 24, 2026

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

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

{
    "created_epoch": "1782259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782259200000",
    "number": "1730005943",
    "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": "2350 KANELL BLVD",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639014036",
            "telephone_number": "573-785-0188",
            "fax_number": "573-785-7321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CEDARGATE AL OPCO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-06-24",
        "last_updated": "2026-06-24",
        "certification_date": "2026-06-24",
        "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": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jamie I Casey, BSW
• Amber Caskey
• Candice Carol Cate
• Catholic Charities of Southern Missouri- Butler/Dunklin Counties
• Holly Michelle Cavness McKinley, RDH
• Cedargate Health Care Center, L.L.C.
• Cedargate Health Care Center, LLC
• Cedargate Healthcare Group, LLC
• Cedargate Opco LLC
• Central Pharmacy

• Assisted Living Facility in Poplar Bluff, MO
• Providers in Poplar Bluff, MO by specialty
• Assisted Living Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 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.