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Southeast Missouri Residential Services

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Poplar Bluff, MO · enumerated 2009 · authorized official Molly Boeckmann, Director of Administrative Services.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1568601482

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Registry record

Entity type Organization (Type 2)
Legal business name Southeast Missouri Residential Services
Practice address 2351 Kanell Blvd, Poplar Bluff, MO, 63901
Phone (573) 840-9300
Fax (573) 840-9373
Enumeration date Feb 17, 2009
Last updated in NPPES Oct 15, 2020

Taxonomy & classification

320900000X Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Residential Treatment Facilities Primary

Authorized official

Name Molly Boeckmann
Title Director of Administrative Services
Phone (573) 751-4055

Other identifiers

Identifier Type State Issuer
856407804 Medicaid MO -

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

Where is Southeast Missouri Residential Services located?
The practice location on file with NPPES is in Poplar Bluff, MO.
How current is this record?
Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2020-10-15. Verify at npiregistry.cms.hhs.gov.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2020-10-15.