| NPI | 1124198981 |
|---|---|
| Doing Business As | SOUTHEAST MISSOURI RESIDENTIAL SERVICES-POPLAR BLUFF |
| Entity Type | Organization |
| Authorized Contact | MOLLY JANE BOECKMANN Director Of Administrative Services 573-751-4055 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities (Licence: MO exempt) |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2020-10-27 |