Taxonomy Code 320900000X(320900000x)
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility. Providers: 14

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Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Providers

NPI Name Type Address

1407994601

MRS. Bonnie Sue Faughn

Individual

2342 County Road 523

Poplar Bluff, MO

1982804324

Prc Enterprises, Inc.

Organization

650 Vine St

Poplar Bluff, MO

1467570085

Mcwilliams Manor, Incorporated

Organization

3439 S Westwood Blvd

Poplar Bluff, MO

1699974196

Beth Gilmore Dba New Foundations Of Living

Organization

191 Hampton Ct

Poplar Bluff, MO

1447520143

B.j. Price, Inc.

Organization

650 Vine St

Poplar Bluff, MO

1033596325

2gethertech Inc.

Organization

351 N Main St

Poplar Bluff, MO

1447638184

Preferred Family Healthcare

Organization

351 N Main St

Poplar Bluff, MO

1699808766

Mcwilliams Manor, Incorporated

Organization

3439 S Westwood Blvd

Poplar Bluff, MO

1629599972

B.j. Price, Inc.

Organization

3439 S Westwood Blvd

Poplar Bluff, MO

1790802916

Willhaven Residential Complex, Inc.

Organization

2698 Debbie Ln

Poplar Bluff, MO

1598906372

State Of Missouri

Organization

2351 Kanell Blvd

Poplar Bluff, MO

1568601482

Southeast Missouri Residential Services

Organization

2351 Kanell Blvd

Poplar Bluff, MO

1275282204

731 Investments, Llc

Organization

5031 Linwood

Poplar Bluff, MO

1053031047

Ozark Behavioral Health, Llc

Organization

2725 N Westwood Blvd

Poplar Bluff, MO

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Taxonomy Code 320900000X
Display Name Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Taxonomy Group Residential Treatment Facilities
Taxonomy Classification Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Definition A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
Effective Date September 30, 2009
Modification Date September 30, 2009
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Other Taxonomy Codes

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364SN0800X • providers: 51

Administrator Registered Nurse

163WA2000X • providers: 1,546

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152WL0500X • providers: 358

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163WN0800X • providers: 146

Primary Care Clinic/Center

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Family Health Clinical Nurse Specialist

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Surgical Critical Care Physician

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207WX0200X • providers: 461

Licensed Vocational Nurse

164X00000X • providers: 15,634

Clinical & Laboratory Immunology (Internal Medicine) Physician

207RI0001X • providers: 38

Microbiology Specialist/Technologist

246QM0900X • providers: 56

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156FX1202X • providers: 52

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