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SOUTHAVEN INC
NPI 1013034602
Assisted Living Facility in Kennett, MO

Active since March 26, 2007
612 SOUTH BY-PASS, KENNETT, MO 63857(573) 888-9213(573) 888-9218 Get Directions Write a Review

NPPES record last updated: July 7, 2008. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Southaven Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTHAVEN INC (NPI 1013034602) is a healthcare organization registered as an assisted living facility in Kennett, Missouri and active in the NPI registry since March 2007. The organization lists Gina Dawn Stoverink, Owner Administrator, as its authorized official.

NPPES Registry Identity

NPI1013034602
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameSOUTHAVEN INC
Location Address612 SOUTH BY-PASSKennett, MO 63857
Mailing Address612 South By-passKennett, MO 63857 · (573) 888-9213 · Fax (573) 888-9218
Phone(573) 888-9213
Fax(573) 888-9218
Organization SubpartNo
Authorized OfficialGina Dawn StoverinkOwner Administrator · (573) 888-9213
Enumeration DateMarch 26, 2007
Last NPPES UpdateJuly 7, 2008
✔ NPI 1013034602 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
License✔ Licensed in MO · 033614
Definition
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.
612 SOUTH BY-PASS, Kennett, MO 63857
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Other Identifiers 1

Medicaid266179704MO

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Southaven Inc's NPI number?

The NPI number for Southaven Inc is 1013034602. It was assigned to this organization in the NPPES registry on March 26, 2007.

Where is Southaven Inc located?

Southaven Inc is located at 612 South By-Pass, Kennett, MO 63857. The listed phone number is (573) 888-9213.

What is Southaven Inc's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

When was this NPI record last updated?

The NPPES record for Southaven Inc was last updated on July 7, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.