OrganizationActive
Southeast Missouri Residential Services
NPI 1568601482 · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Poplar Bluff, MO
Provider details
- NPI number
- 1568601482
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Molly Boeckmann, Director of Administrative Services(573) 751-4055
Specialties & taxonomies
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityPrimary320900000X
Residential Treatment Facilities
Profile Score
Detailed profile(86/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
17 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
2351 Kanell Blvd
Poplar Bluff, MO 63901-4035
Phone: (573) 840-9300
Fax: (573) 840-9373
Approximate (ZIP-level) locationGet directions
Mailing address
2351 Kanell Blvd
Poplar Bluff, MO 63901-4035
Registry dates
- Enumerated
- 2009-02-17
- Last updated
- 2020-10-15
- Certified
- 2020-10-15
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.