NPI 1063582708

State of Missouri

Organisation Case Management Agency Poplar Bluff, MO

Practice location

Address: 2351 Kanell Blvd, Poplar Bluff, MO 63901-4035
Phone: (573) 840-9300
Fax: (573) 840-9311
Mailing address: 1706 E Elm St, Jefferson City, MO 65101-4130

Authorised official

Name: Molly Jane Boeckmann
Title: Director of Administrative Services
Phone: (573) 751-4055

Registered specialties

Case Management Agency Primary

Agencies Taxonomy 251B00000X Licence EXEMPT (MO)

Other Case Management providers in Missouri →

Registry record

NPI: 1063582708
Entity type: Organization
NPI issued: 9 Nov 2006
Record last updated: 20 Oct 2020

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.