Southeast Missouri Residential Services
LBN: Southeast Missouri Residential Services
Southeast Missouri Residential Services is an health care organization with primary practice located at 2351 Kanell Blvd , Poplar Bluff MO 63901-4035. The organization recently has only one registered license in Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities, which is considered as the primary health care specialty.
Southeast Missouri Residential Services can be contacted via phone (573) 840-9300, or through Boeckmann, Molly Jane via phone (573) 751-4055.
Contact Information
Primary practice address
2351 Kanell Blvd
Poplar Bluff MO 63901-4035
Phone: (573) 840-9300
Fax: (573) 840-9373
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 320900000X |
Profile Details
| NPI number | 1568601482 |
|---|---|
| LBN Legal business name | Southeast Missouri Residential Services |
| DBA Doing business as | |
| Authorized official | Boeckmann, Molly Jane |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Feb 17th, 2009 |
| Last updated | Oct 15th, 2020 - about 5 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1568601482 | NPPES |
| Missouri | MEDICAID | 856407804 |
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