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Organization

MIDWEST HEALTH CARE, LLC

Active
Other names
The Cedargate
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JIFI JACOB (MANAGER)
(618) 628-7671
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
031347
MO
314000000X
Skilled Nursing Facility
Primary
037135
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
101482008
MO
Enumeration date
03/30/2007
Last updated
08/03/2009
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