POPLAR BLUFF RESIDENTIAL LLC NPI 1780630061

NPI Information

POPLAR BLUFF RESIDENTIAL, LLC is an assisted living facility in Poplar Bluff, MO. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. POPLAR BLUFF RESIDENTIAL, LLC NPI is 1780630061. The provider is registered as an organization entity type.
The provider Is Doing Business As River Mist Assisted Living.

The provider's business location address is:

2050 W MAUD ST
POPLAR BLUFF, MO
ZIP 63901-000
Phone: (573) 686-2833

The provider's authorized official is James Reiker .
The authorized official title is Treasurer and has the following contact phone number (573) 471-1113.

The CLIA number assigned to this NPI record is 26D0887468 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/26/2006 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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