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Southeast Missouri Residential Services
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Poplar Bluff, Missouri
NPI 1568601482

Southeast Missouri Residential Services is a Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility based in Poplar Bluff, MO. Southeast Missouri Residential Services practices in Poplar Bluff, MO. The NPI Number for Southeast Missouri Residential Services is 1568601482 and holds a License No. (Missouri).

The current practice location address for Southeast Missouri Residential Services is 2351 Kanell Blvd, Poplar Bluff, MO and can be reached out via phone at 573-840-9300 and via fax at 573-840-9373.

Location: 2351 Kanell Blvd, Poplar Bluff, MO, 63901-4035
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1568601482
Provider Name
Southeast Missouri Residential Services
Credential
Provider Entity Type
Organization
Address
2351 Kanell Blvd, Poplar Bluff, MO, 63901-4035
Phone Number
573-840-9300
Fax Number
573-840-9373
Provider Enumeration Date
02/17/2009
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
856407804 05 MO
institution
Provider Business Practice Location Address Details
Address
2351 Kanell Blvd
City
Poplar Bluff
State
Missouri
Zip
63901-4035
Phone Number
573-840-9300
Fax Number
573-840-9373
person
Provider Business Mailing Address Details
Address
2351 Kanell Blvd
City
Poplar Bluff
State
Missouri
Zip
63901-4035
Phone Number
573-840-9300
Fax Number
573-840-9373
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.
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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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