Provider Demographics
NPI:1518713460
Name:ASPIRE SENIOR LIVING POPLAR BLUFF, LLC
Entity type:Organization
Organization Name:ASPIRE SENIOR LIVING POPLAR BLUFF, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:STADTMUELLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-957-1010
Mailing Address - Street 1:19401 E US HIGHWAY 40 STE 120
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64055-5400
Mailing Address - Country:US
Mailing Address - Phone:816-957-1010
Mailing Address - Fax:
Practice Address - Street 1:3001 MAY ST
Practice Address - Street 2:
Practice Address - City:POPLAR BLUFF
Practice Address - State:MO
Practice Address - Zip Code:63901-1942
Practice Address - Country:US
Practice Address - Phone:573-686-6999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-30
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility