NPI 1013034602

Southaven INC

Organisation Assisted Living Facility Kennett, MO

Practice location

Address: 612 South By-Pass, Kennett, MO 63857
Phone: (573) 888-9213
Fax: (573) 888-9218

Authorised official

Name: Gina Dawn Stoverink
Title: Owner Administrator
Phone: (573) 888-9213

Registered specialties

Assisted Living Facility Primary

Nursing & Custodial Care Facilities Taxonomy 310400000X Licence 033614 (MO)

Other Assisted Living Facility providers in Missouri →

Registry record

NPI: 1013034602
Entity type: Organization
NPI issued: 26 Mar 2007
Record last updated: 7 Jul 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.