State Of Missouri in Jefferson City - Intermediate Care Facility, Intellectual Disabilities
State Of Missouri - NPI 1376614701
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 1376614701. The last update date is 2020-09-03.
State Of Missouri's current location address is Po Box 687, Jefferson City, Missouri. You can contact this provider via phone number 5735266895 and fax number 5735264560. The mailing address for State Of Missouri is Po Box 687, Jefferson City, Missouri. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | State Of Missouri |
|---|---|
| Address | Po Box 687, Jefferson City, Missouri |
| Phone Number | 5735266895 |
| 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 | 1376614701 |
|---|---|
| Provider Enumeration Date | 2006-11-09 |
| Last Updated Date | 2020-09-03 |
Provider Mailing Address Detail
| Address | Po Box 687 |
|---|---|
| City | Jefferson City |
| State | Missouri (MO) |
| Post Code | 651020687 |
| Phone Number | 5735266895 |
| Fax Number | 5735264560 |
Provider's Primary Taxonomy Detail
| Speciality | Intermediate Care Facility, Intellectual Disabilities |
|---|---|
| Taxonomy | 315P00000X |
| Licence No | EXEMPT |
|
Definition: An intermediate care facility providing services for individuals with intellectual disabilities. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 51499903 | MO | -- |
Post Comment/ Review Below
What is the unique 10-digit identification code issued to State Of Missouri by the Centers for Medicare & Medicaid Services?
The State Of Missouri has been assigned the NPI (National Provider Identifier) 1376614701 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Can you provide the State Of Missouri's physical address?
The State Of Missouri is physically located at Po Box 687, in the city of Jefferson City, MO, with the postal code 651020687.
What is State Of Missouri's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for State Of Missouri is Intermediate Care Facility, Intellectual Disabilities, and the corresponding taxonomy classification code for this specialized field is 315P00000X.
When did State Of Missouri receive its 1376614701 assignment?
The State Of Missouri was assigned its 1376614701 on 2006-11-09, which is the date when this unique identifier was issued to the organization.
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 2020-09-03.