SON SHINE HOME INC
Residential Treatment Facilities at Hwy Aa, Poplar Bluff, MO

License number
Missouri 14308791
Category
Residential Treatment Facilities
Type
Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities
Owner
Name: MRS. LEOTA FAYE DICKEN
Title: ADMINISTRATOR PRES OF CORP OWNER
Phone: (573) 785-0482
Address
Address
2056 Highway Aa, Poplar Bluff, MO 63901
National Provider ID: 1114064508
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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SON SHINE HOME, INC

Poplar Bluff, MO

Registration:
Dec 7, 1992
Addresses:
2056 Hwy Aa, Poplar Bluff, MO 63901 (Physical)
2056 Hwy Aa 2056 Hwy Aa, Poplar Bluff, MO 63901 (Physical)
State ID:
00373969
Business type:
Gen. Business - For Profit
Expiration:
Perpetual
Agent:
Leota F. Dicken,2056 Hwy Aa, Poplar Bluff, MO 63901 (Physical)

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