Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

State of Missouri

Organization Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · NPI 1598906372

State of Missouri is an Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Poplar Bluff, Missouri. Registered with an NPI since 2009.

In the registry since
2009

Practice location Address checks out

2351 Kanell Blvd
Poplar Bluff, MO 63901-4035
Phone: (573) 840-9374
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (primary) Taxonomy 320900000X

Record details

NPI number1598906372
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationState of Missouri
Authorized official Molly Boeckmann — Director Of Administrative Services · (573) 751-4055
Other names Southeast Missouri Residential Services Isl; Southeast Missouri Residential Services Isl
NPI enumeratedMarch 9, 2009
Last updated in NPPESSeptember 3, 2020
Certification dateSeptember 3, 2020
Mailing address1706 E Elm St, Jefferson City, MO 65101-4130

Other providers in Poplar Bluff