Son Shine Home INC
NPI #1114064508 in Poplar Bluff, Missouri
Provider Information
- NPI Number
- 1114064508
- Entity Type
- Organization
- Organization Name
- Son Shine Home INC
- Primary Specialty
- Residential Treatment Facility, Intellectual and/or Developmental Disabilities
- Enumeration Date
- Feb 1, 2007
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 2056 HWY AA
- City
- Poplar Bluff
- State
- Missouri
- ZIP Code
- 63901-3789
- Phone
- (573) 785-0482
Authorized Official
- Name
- MRS. LEOTA FAYE DICKEN
- Title
- ADMINISTRATOR PRES OF CORP OWNER
- Phone
- (573) 785-0482
Specialties & Taxonomy Codes
| Specialty |
|---|
| Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
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