State of Missouri
NPI 1124198981ActiveOrganization· Intermediate Care Facility, Intellectual Disabilities· Poplar Bluff, MO
Intermediate Care Facility, Intellectual Disabilities in Poplar Bluff, Missouri, registered in NPPES in November 2006, part of State of Missouri. The authorized official on file is Molly Jane Boeckmann, Director Of Administrative Services.
Overview
| NPI | 1124198981 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | State of Missouri |
| NPI issued | Nov 9, 2006 |
| Last updated in NPPES | Oct 27, 2020 |
| Certified by provider | Oct 27, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Intermediate Care Facility, Intellectual Disabilities Primary | 315P00000X | EXEMPT | MO |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|