Willhaven Residential Complex, Inc.

NPI #1790802916 in Poplar Bluff, Missouri

Provider Information

NPI Number: 1790802916
Entity Type: Organization
Organization Name: Willhaven Residential Complex, Inc.
Primary Specialty: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Mar 23, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: 2698 DEBBIE LN
City: Poplar Bluff
State: Missouri
ZIP Code: 63901-2629
Phone: (573) 686-4700

Authorized Official

Name: MR. DAIREL L. DENTON JR., CPA,CFP,CFS,BCM,BCE
Title: PRES.
Phone: (573) 686-3053

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320900000X	Primary

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