SOUTHEAST MISSOURI RESIDENTIAL SERVICES
NPI 1568601482
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Poplar Bluff, MO
NPI Status: Active since February 17, 2009
Contact Information
2351 KANELL BLVD
POPLAR BLUFF, MO
ZIP 63901
Phone: (573) 840-9300
Fax: (573) 840-9373
- Organization
- Community Based Residential Treatment Fa...
- CLIA Number: 26D1057142
- CLIA Cert. Type: Ancillary Testing Site in Health Care Center
- CLIA Exp. Date: 07-31-2026
About SOUTHEAST MISSOURI RESIDENTIAL SERVICES
This page provides the complete NPI Profile along with additional information for Southeast Missouri Residential Services, a provider established in Poplar Bluff, Missouri operating as a Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities. The healthcare provider is registered in the NPI registry with number 1568601482 assigned on February 2009. The practitioner's primary taxonomy code is 320900000X. The provider is registered as an organization and their NPI record was last updated 6 years ago. The authorized official of this NPI record is Molly Jane Boeckmann (Director Of Administrative Services)
- NPI
- 1568601482
- Provider Name
- SOUTHEAST MISSOURI RESIDENTIAL SERVICES
- Entity Type
- Organization
- Location Address
- 2351 KANELL BLVD POPLAR BLUFF, MO 63901
- Location Phone
- (573) 840-9300
- Location Fax
- (573) 840-9373
- Mailing Address
- 2351 KANELL BLVD POPLAR BLUFF, MO 63901
- Mailing Phone
- (573) 840-9300
- Mailing Fax
- (573) 840-9373
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 02-17-2009
- Last Update Date
- 10-15-2020
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
- Taxonomy Code
- 320900000X
- Type
- Residential Treatment Facilities
- Taxonomy Description
- A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 856407804 | MEDICAID (05) | MO |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 26D1057142
- Facility Type
- Ancillary Testing Site in Health Care Center
- Certificate Effective Date
- August 01, 2024
- Certificate Expiration Date
- July 31, 2026
- Laboratory Director
- LAUREN E. THOMAS
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Southeast Missouri Residential Services to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
Reviews for SOUTHEAST MISSOURI RESIDENTIAL SERVICES
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1568601482, we treat the final digit (2) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 58. The final step is to find the difference between that total and the next multiple of ten (60 - 58 = 2).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 58 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 5 providers are registered at the same or a nearby location.
POPLAR BLUFF, MO 63901
POPLAR BLUFF, MO 63901
POPLAR BLUFF, MO 63901
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1568601482, enumerated as an "organization" on February 17, 2009.
The provider is located at 2351 KANELL BLVD POPLAR BLUFF, MO 63901 and the phone number is (573) 840-9300.
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities with taxonomy code 320900000X.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
