Portageville SNF Opco LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

PORTAGEVILLE SNF OPCO LLC

Practice address

290 W State Highway 162
Portageville, MO 63873-9397

Phone

(573) 379-2017

Fax

(573) 379-2735

NPI assigned

Jun 22, 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

Other names 1

• Portageville 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": "1821924341",
    "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": "290 W STATE HIGHWAY 162",
            "city": "PORTAGEVILLE",
            "state": "MO",
            "postal_code": "638739397",
            "telephone_number": "573-379-2017",
            "fax_number": "573-379-2735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTAGEVILLE 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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Portageville Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• N & R of Portageville, Inc.
• Pemiscot County Memorial Hospital
• Portageville Health Care Center, L.L.C.
• Portageville Nursing and Rehabilitation, LLC
• Portageville School District
• Dennis Reed, PA
• Remember Forever Day Treatment, LLC
• Donald D Rone III, PHARM D
• Mary Samples
• Audrey H Shelly, PHARMD

• Skilled Nursing Facility in Portageville, MO
• Providers in Portageville, 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.