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Southaven Inc
Assisted Living Facility in Kennett, Missouri
NPI 1013034602

Southaven Inc is an Assisted Living Facility based in Kennett, MO. Southaven Inc practices in Kennett, MO. The NPI Number for Southaven Inc is 1013034602 and holds a License No. 033614 (Missouri).

The current practice location address for Southaven Inc is 612 South By-Pass, Kennett, MO and can be reached out via phone at 573-888-9213 and via fax at 573-888-9218.

Location: 612 South By-Pass, Kennett, MO, 63857
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1013034602
Provider Name
Southaven Inc
Credential
Provider Entity Type
Organization
Address
612 South By-Pass, Kennett, MO, 63857
Phone Number
573-888-9213
Fax Number
573-888-9218
Provider Enumeration Date
03/26/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
266179704 05 MO
institution
Provider Business Practice Location Address Details
Address
612 South By-Pass
City
Kennett
State
Missouri
Zip
63857
Phone Number
573-888-9213
Fax Number
573-888-9218
person
Provider Business Mailing Address Details
Address
612 South By-Pass
City
Kennett
State
Missouri
Zip
63857
Phone Number
573-888-9213
Fax Number
573-888-9218
person
Provider's Taxonomy Details 1
Type
Nursing & Custodial Care Facilities
Classification
Assisted Living Facility
Speciality
-
Taxonomy
310400000X
License No.
033614 (Missouri)
Definition
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.
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