Organization
CEDARGATE HEALTHCARE GROUP, LLC
Active
Other names
CEDARGATE HEALTHCARE
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KIMBERLY D SMITH NHA (CFO/OWNER)
(731) 588-4302
Entity
Organization
Contact information
Practice address
2350 KANELL BLVD, POPLAR BLUFF, MO 63901-4036
(573) 785-0188
(573) 785-7321
Mailing address
2350 KANELL BLVD, POPLAR BLUFF, MO 63901-4036
(573) 785-0188
(573) 785-7321
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
042291
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101482008
—
MO
Enumeration date
10/17/2014
Last updated
01/05/2015
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