Maple Crest Residential Care Facility
NPI #1619147428 in Poplar Bluff, Missouri
Provider Information
- NPI Number
- 1619147428
- Entity Type
- Organization
- Organization Name
- Maple Crest Residential Care Facility
- Primary Specialty
- Community Based Residential Treatment Facility, Mental Illness
- Enumeration Date
- Mar 7, 2008
- Last Updated
- Mar 7, 2008
Practice Location
- Address
- 307 N BROADWAY ST
- City
- Poplar Bluff
- State
- Missouri
- ZIP Code
- 63901-5103
- Phone
- (573) 686-4490
Authorized Official
- Name
- MR. MARK ALLEN KEENEY
- Title
- OWNER
- Phone
- (573) 686-4490
Specialties & Taxonomy Codes
| Specialty |
|---|
| Community Based Residential Treatment Facility, Mental Illness |
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