Organization · Type 2 NPI

Willhaven Residential Complex, Inc.

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Poplar Bluff, MO

NPI number 1790802916 Active

Practice location

2698 Debbie Ln
Poplar Bluff, MO 63901-2629

Call (573) 686-4700 Map

Mailing address

PO Box 1054
Poplar Bluff, MO 63902-1054

Specialties and licenses

TaxonomyCodeLicense
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary 320900000XN00027062 (MO)

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility: A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.

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About NPI 1790802916

Willhaven Residential Complex, Inc.'s National Provider Identifier is 1790802916, issued on Mar 23, 2007. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (320900000X), and the practice location is in Poplar Bluff, MO. The record was last updated on Aug 22, 2020.