Southeast Missouri Residential Services Isl

LBN: State Of Missouri
Southeast Missouri Residential Services Isl 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. State Of Missouri can be contacted via phone (573) 840-9374, 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) 840-9374
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Boeckmann, Molly Jane
Phone: (573) 751-4055

Health care specialties

SpecialtyCodeLicense #State
Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 320900000X

Profile Details

NPI number 1598906372
LBN Legal business name State Of Missouri
DBA Doing business as Southeast Missouri Residential Services Isl
Authorized official Boeckmann, Molly Jane
Entity Organization
Organization subpart 1 Yes
Enumeration date Mar 9th, 2009
Last updated Sep 3rd, 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.

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