State Of Missouri in Jefferson City - Intermediate Care Facility, Intellectual Disabilities
State Of Missouri - NPI 1164630463
State Of Missouri is a Intermediate Care Facility, Intellectual Disabilities in Jefferson City, Missouri. State Of Missouri practices all healthcare services and medical treatments related to Intermediate Care Facility, Intellectual Disabilities. The NPI Number for State Of Missouri is 1164630463. The last update date is 2020-10-27.
State Of Missouri's current location address is 1706 E Elm St, Jefferson City, Missouri. You can contact this provider via phone number 5737513398 and fax number 5735264560. The mailing address for State Of Missouri is 1706 E Elm St, Jefferson City, Missouri. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | State Of Missouri |
|---|---|
| Address | 1706 E Elm St, Jefferson City, Missouri |
| Phone Number | 5737513398 |
| Fax Number | 5735264560 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | DIRECTOR O |
|---|---|
| Authorized Official Name | Boeckmann Jane Molly |
| Telephone Number | 5737514055 |
NPI Number Detail
| NPI Number | 1164630463 |
|---|---|
| Provider Enumeration Date | 2007-05-18 |
| Last Updated Date | 2020-10-27 |
Provider Mailing Address Detail
| Address | 1706 E Elm St |
|---|---|
| City | Jefferson City |
| State | Missouri (MO) |
| Post Code | 651014130 |
| Phone Number | 5737513398 |
| Fax Number | 5735264560 |
Provider's Primary Taxonomy Detail
| Speciality | Intermediate Care Facility, Intellectual Disabilities |
|---|---|
| Taxonomy | 315P00000X |
|
Definition: An intermediate care facility providing services for individuals with intellectual disabilities. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 52361904 | MO | -- |
Post Comment/ Review Below
What is the State Of Missouri's 1164630463?
The State Of Missouri's NPI (National Provider Identifier) Number is 1164630463. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Could you share the physical location details of State Of Missouri?
The State Of Missouri is situated at 1706 E Elm St, in the city of Jefferson City, state of MO, with the zip code 651014130.
What is State Of Missouri's specialized field of practice, and what is the corresponding taxonomy classification code?
The State Of Missouri's area of specialization is Intermediate Care Facility, Intellectual Disabilities, and the corresponding taxonomy code that categorizes this field of practice is 315P00000X.
When did the State Of Missouri receive its 1164630463?
The State Of Missouri was issued its 1164630463 on 2007-05-18, which is the date when the organization was assigned this unique identifier.
As of what date were the details pertaining to State Of Missouri last refreshed?
The information related to the State Of Missouri, including its address, specialty, and other relevant details, was last updated on 2020-10-27.
NPI Number: 1184627523
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