NPI 1013096544

State of Missouri

Organisation Psychiatric Residential Treatment Facility Cape Girardeau, MO

Practice location

Address: 1025 N Sprigg St, Cape Girardeau, MO 63701-4831
Phone: (573) 290-5888
Fax: (573) 290-5895
Mailing address: PO Box 687, Jefferson City, MO 65102-0687

Authorised official

Name: Molly Jane Boeckmann
Title: Director of Adminstrative Services
Phone: (573) 751-4055

Registered specialties

Psychiatric Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 323P00000X Licence EXEMPT (MO)

Other Psychiatric Residential Treatment Facility providers in Missouri →

Registry record

NPI: 1013096544
Entity type: Organization
NPI issued: 3 Nov 2006
Record last updated: 28 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.