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Mrs. Bonnie Sue Faughn
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Poplar Bluff, Missouri
NPI 1407994601

Bonnie Sue Faughn is a Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility based in Poplar Bluff, MO. Bonnie Sue Faughn practices in Poplar Bluff, MO. The NPI Number for Bonnie Sue Faughn is 1407994601 and holds a License No. (Missouri).

The current practice location address for Bonnie Sue Faughn is 2342 County Road 523, Poplar Bluff, MO and can be reached out via phone at 573-686-6142.

Location: 2342 County Road 523, Poplar Bluff, MO, 63901-8017
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1407994601
Provider Name
Bonnie Sue Faughn
Credential
Provider Entity Type
Individual
Gender
Female
Address
2342 County Road 523, Poplar Bluff, MO, 63901-8017
Phone Number
573-686-6142
Fax Number
Provider Enumeration Date
02/01/2007
Last Update Date
03/08/2024
institution
Provider Business Practice Location Address Details
Address
2342 County Road 523
City
Poplar Bluff
State
Missouri
Zip
63901-8017
Phone Number
573-686-6142
Fax Number
person
Provider Business Mailing Address Details
Address
2342 County Road 523
City
Poplar Bluff
State
Missouri
Zip
63901-8017
Phone Number
573-686-6142
Fax Number
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
320900000X
License No.
()
Definition
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
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