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WILLHAVEN RESIDENTIAL COMPLEX, INC.
NPI 1790802916
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Poplar Bluff, MO

Active since March 23, 2007
2698 DEBBIE LN, POPLAR BLUFF, MO 63901(573) 686-4700 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Willhaven Residential Complex, Inc. NPPES

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

WILLHAVEN RESIDENTIAL COMPLEX, INC. (NPI 1790802916) is a healthcare organization registered as a community based residential treatment facility, intellectual and/or developmental disabilities in Poplar Bluff, Missouri and active in the NPI registry since March 2007. The organization lists Dairel L. Denton, Pres., as its authorized official.

NPPES Registry Identity

NPI1790802916
Entity TypeOrganization
Primary Taxonomy320900000X
Legal Business NameWILLHAVEN RESIDENTIAL COMPLEX, INC.
Location Address2698 DEBBIE LNPoplar Bluff, MO 63901-2629
Mailing AddressPo Box 1054Poplar Bluff, MO 63902-1054 · (573) 686-4700 · Fax (573) 686-1441
Phone(573) 686-4700
Organization SubpartNo
Authorized OfficialDairel L. DentonPres. · (573) 686-3053
Enumeration DateMarch 23, 2007
Last NPPES UpdateAugust 22, 2020
✔ NPI 1790802916 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCommunity Based Residential Treatment Facility, Intellectual and/or Developmental DisabilitiesResidential Treatment Facilities
Taxonomy Code320900000X
License✔ Licensed in MO · N00027062
Definition
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities.
2698 DEBBIE LN, Poplar Bluff, MO 63901
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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 Willhaven Residential Complex, Inc.'s NPI number?

The NPI number for Willhaven Residential Complex, Inc. is 1790802916. It was assigned to this organization in the NPPES registry on March 23, 2007.

Where is Willhaven Residential Complex, Inc. located?

Willhaven Residential Complex, Inc. is located at 2698 Debbie Ln, Poplar Bluff, MO 63901. The listed phone number is (573) 686-4700.

What is Willhaven Residential Complex, Inc.'s specialty?

The primary specialty registered for this NPI is Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities with taxonomy code 320900000X.

When was this NPI record last updated?

The NPPES record for Willhaven Residential Complex, Inc. was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.