PORTAGEVILLE SNF OPCO LLC
NPI 1821924341
Skilled Nursing Facility in Portageville, MO

Active since June 22, 2026CLIA 26D0673298 · Waiver
290 W STATE HIGHWAY 162, PORTAGEVILLE, MO 63873(573) 379-2017(573) 379-2735 Get Directions Write a Review

NPPES record last updated: June 22, 2026. Verified against the NPPES registry weekly; last sync: September 20, 2026.

About Portageville Snf Opco Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PORTAGEVILLE SNF OPCO LLC (NPI 1821924341), doing business as Portageville Health Care Center, is a healthcare organization registered as a skilled nursing facility in Portageville, Missouri and active in the NPI registry since June 2026. The organization holds a CLIA Waiver certificate valid through August 31, 2028 and lists Nicholas Destefane, President, as its authorized official.

NPPES Registry Identity

NPI1821924341
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NamePORTAGEVILLE SNF OPCO LLC
Location Address290 W STATE HIGHWAY 162Portageville, MO 63873-9397
Mailing Address1869 Craig Park CtSaint Louis, MO 63146-4122 · (314) 543-3800 · Fax (314) 543-3800
Fax(573) 379-2735
Organization SubpartNo
Authorized OfficialNicholas DestefanePresident · (314) 543-3800
Enumeration DateJune 22, 2026
NPPES CertifiedJune 22, 2026
✔ NPI 1821924341 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
Definition
(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.
290 W STATE HIGHWAY 162, Portageville, MO 63873

Other Names 1

Doing Business AsPortageville Health Care Center

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 26D0673298

Portageville Health Care Center · Portageville, MO
Active · expires Aug 31, 2028
CLIA Number26D0673298
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateSeptember 1, 2026
Certificate Expiration DateAugust 31, 2028
Laboratory DirectorJean Rice
Laboratory Phone(573) 379-2017
Laboratory LocationPortageville Health Care Center290 West Highway 162, Portageville, MO 63873
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Skilled Nursing Facility
290 W STATE HIGHWAY 162
PORTAGEVILLE, MO 63873
Skilled Nursing Facility
290 W STATE HIGHWAY 162
PORTAGEVILLE, MO 63873
Skilled Nursing Facility
290 W STATE HIGHWAY 162
PORTAGEVILLE, MO 63873
Skilled Nursing Facility
290 W STATE HIGHWAY 162
PORTAGEVILLE, MO 63873

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Portageville Snf Opco LLC's NPI number?

The NPI number for Portageville Snf Opco LLC is 1821924341. It was assigned to this organization in the NPPES registry on June 22, 2026. The provider is doing business as Portageville Health Care Center.

Where is Portageville Snf Opco LLC located?

Portageville Snf Opco LLC is located at 290 W State Highway 162, Portageville, MO 63873. The listed phone number is (573) 379-2017.

What is Portageville Snf Opco LLC's specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.

Does Portageville Snf Opco LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 26D0673298) is associated with this NPI, valid through August 31, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Portageville Snf Opco LLC was last updated on June 22, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.