SOUTHEAST MISSOURI RESIDENTIAL SERVICES-SIKESTON
NPI 1598844029
Intermediate Care Facility, Intellectual Disabilities in Sikeston, MO

Active since November 03, 2006
112 PLAZA DR, SIKESTON, MO 63801(573) 472-5300(573) 472-5308 Get Directions Write a Review

NPPES record last updated: October 27, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Oct 27, 2020, Aug 28, 2019 (2 updates tracked since 2019).

About Southeast Missouri Residential Services-sikeston NPPES

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

SOUTHEAST MISSOURI RESIDENTIAL SERVICES-SIKESTON (NPI 1598844029) is a healthcare organization registered as an intermediate care facility, intellectual disabilities in Sikeston, Missouri and active in the NPI registry since November 2006. The organization lists Molly Jane Boeckmann, Director Of Administrative Services, as its authorized official.

NPPES Registry Identity

NPI1598844029
Entity TypeOrganization
Primary Taxonomy315P00000X
Legal Business NameSTATE OF MISSOURI
Location Address112 PLAZA DRSikeston, MO 63801-5137
Mailing AddressPo Box 687Jefferson City, MO 65102-0687 · (573) 751-3398 · Fax (573) 526-4560
Fax(573) 472-5308
Organization SubpartYes
Authorized OfficialMolly Jane BoeckmannDirector Of Administrative Services · (573) 751-4055
Enumeration DateNovember 3, 2006
Last NPPES UpdateOctober 27, 20202 updates tracked since enumeration
NPPES CertifiedOctober 27, 2020
NPI 1598844029 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyIntermediate Care Facility, Intellectual DisabilitiesNursing & Custodial Care Facilities
Taxonomy Code315P00000X
License Licensed in MO · EXEMPT
Definition

An intermediate care facility providing services for individuals with intellectual disabilities.

112 PLAZA DR, Sikeston, MO 63801

Other Names 1

Doing Business AsSoutheast Missouri Residential Services-sikeston

Other Identifiers 1

Medicaid051793206MO

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Day Training, Developmentally Disabled Services
112 PLAZA DR
SIKESTON, MO 63801
Case Management
112 PLAZA DR
SIKESTON, MO 63801
Emergency Medicine
112 PLAZA DR
SIKESTON, MO 63801
Family Medicine
112 PLAZA DR
SIKESTON, MO 63801

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 State Of Missouri's NPI number?

The NPI number for State Of Missouri is 1598844029. It was assigned to this organization in the NPPES registry on November 3, 2006. The provider is doing business as Southeast Missouri Residential Services-Sikeston.

Where is State Of Missouri located?

State Of Missouri is located at 112 Plaza Dr, Sikeston, MO 63801. The listed phone number is (573) 472-5300.

What is State Of Missouri's specialty?

The primary specialty registered for this NPI is Intermediate Care Facility, Intellectual Disabilities with taxonomy code 315P00000X.

When was this NPI record last updated?

The NPPES record for State Of Missouri was last updated on October 27, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.