Cedargate Health Care Center, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

CEDARGATE HEALTH CARE CENTER, LLC

Doing business as

Cedargate Health Care Center

Practice address

2350 Kanell Blvd
Poplar Bluff, MO 63901-4036

Phone

(573) 785-0188

NPI assigned

Jul 9, 2025

Organization subpart

No

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

Authorized official

Name

Richard J. Destefane

Title

President

Phone

(314) 543-3816

Specialties & licenses 2

Addresses

Other names 1

• Cedargate Health Care Center Doing business as

Tax ID family

Cedargate Health Care Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Cedargate Health Care Center, L.L.C.

  • Assisted Living Facility
  • Poplar Bluff, MO
  • NPI 1124918115
  NPD tax ID

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

{
    "created_epoch": "1752019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763942400000",
    "number": "1922998988",
    "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": "314-543-3816",
            "fax_number": "314-226-1736"
        },
        {
            "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"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CEDARGATE HEALTH CARE CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-09",
        "last_updated": "2025-11-24",
        "certification_date": "2025-11-24",
        "status": "A",
        "authorized_official_last_name": "DESTEFANE",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "314-543-3816"
    },
    "taxonomies": [
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cedargate Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Cedargate Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Candice Carol Cate
• Catholic Charities of Southern Missouri- Butler/Dunklin Counties
• Holly Michelle Cavness McKinley, RDH
• Cedargate Al Opco LLC
• Cedargate Health Care Center, L.L.C.
• Cedargate Healthcare Group, LLC
• Cedargate Opco LLC
• Central Pharmacy
• Chamberlain Emergency Group, LLC
• Natalie Chambers

• Skilled Nursing Facility in Poplar Bluff, MO
• Providers in Poplar Bluff, 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 Nov 24, 2025; 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.