Southeast Missouri Residential Services

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

SOUTHEAST MISSOURI RESIDENTIAL SERVICES

Practice address

2351 Kanell Blvd
Poplar Bluff, MO 63901-4035

Phone

(573) 840-9300

Fax

(573) 840-9373

NPI assigned

Feb 17, 2009

Last updated

Oct 15, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Molly Jane Boeckmann

Title

Director of Administrative Services

Phone

(573) 751-4055

Specialties & licenses 1

Addresses

Tax ID family

Missouri Tuberculosis Lab104 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

• State of Missouri

  dba Hannibal Regional Center

  • Case Management Agency
  • Hannibal, MO
  • NPI 1427128164
  NPD tax ID
• State of Missouri

  dba Southeast MO Mental Health Center

  • Psychiatry Physician
  • Farmington, MO
  • NPI 1437106705
  NPD tax ID
• State of Missouri

  dba Hawthorn Children's Psychiatric Hosptial

  • Case Management Agency
  • Saint Louis, MO
  • NPI 1437360260
  NPD tax ID
• State of Missouri

  dba Division of Youth Services

  • Rehabilitation Counselor
  • Jefferson City, MO
  • NPI 1437781499
  NPD tax ID
• State of Missouri

  dba CPR Adult

  • Rehabilitation Psychologist
  • Jefferson City, MO
  • NPI 1447886288
  NPD tax ID
• State of Missouri

  dba Hannibal Regional Center

  • Developmentally Disabled Services Day Training Agency
  • Hannibal, MO
  • NPI 1487714515
  NPD tax ID
• State of Missouri

  dba Hawthorn Children's Psychiatric Hosptial

  • Psychiatric Residential Treatment Facility
  • Saint Louis, MO
  • NPI 1487721379
  NPD tax ID
• State of Missouri

  dba Higginsville Habilitation Center-Crisis

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Higginsville, MO
  • NPI 1487931358
  NPD tax ID
• State of Missouri

  dba Marshall Habilitation Center-Home 1

  • Developmentally Disabled Services Day Training Agency
  • Marshall, MO
  • NPI 1518027127
  NPD tax ID
• State of Missouri

  dba Nevada Habilitation Center-Crisis

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Nevada, MO
  • NPI 1528333085
  NPD tax ID
• State of Missouri

  dba Southeast Missouri Residential Services-Sikeston Prof Grp

  • Family Medicine Physician
  • Sikeston, MO
  • NPI 1528348430
  NPD tax ID
• State of Missouri

  dba Central Missouri Regional Center

  • Developmentally Disabled Services Day Training Agency
  • Columbia, MO
  • NPI 1548322605
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1234828800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602720000000",
    "number": "1568601482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2351 KANELL BLVD",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639014035",
            "telephone_number": "573-840-9300",
            "fax_number": "573-840-9373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2351 KANELL BLVD",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639014035",
            "telephone_number": "573-840-9300",
            "fax_number": "573-840-9373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST MISSOURI RESIDENTIAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-17",
        "last_updated": "2020-10-15",
        "certification_date": "2020-10-15",
        "status": "A",
        "authorized_official_last_name": "BOECKMANN",
        "authorized_official_first_name": "MOLLY",
        "authorized_official_middle_name": "JANE",
        "authorized_official_title_or_position": "DIRECTOR OF ADMINISTRATIVE SERVICES",
        "authorized_official_telephone_number": "573-751-4055"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Southeast Health Pharmacy LLC (SoutheastHEALTH Pharmacy)
• Southeast Missouri Anesthesia Partners LLC
• Southeast Missouri Behavioral Health
• Southeast Missouri Community Treatment Center Inc
• Southeast Missouri Community Treatment Center, Inc.
• Southeast Rehabilitation, LLC (Poplar Bluff Rehabilitation)
• Southeasthealth Hospital Holdings, LLC (Southeasthealth)
• Southern Care and Comfort in Home Agency, LLC
• Southern Missouri Sleep Center, LLC
• Southern Missouri Sleep Center, LLC

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Poplar Bluff, MO
• Providers in Poplar Bluff, MO by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.