NPI 1104878792

State of Missouri

Organisation Psychiatric Hospital Fulton, MO

Practice location

Address: 600 E 5th St, Fulton, MO 65251-1753
Phone: (573) 592-4100
Fax: (573) 592-3100
Mailing address: PO Box 687 Admin-Reimbursement Section, Jefferson City, MO 65102-0687

Authorised official

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

Registered specialties

Psychiatric Hospital Primary

Hospitals Taxonomy 283Q00000X Licence EXEMPT (MO)

Other Psychiatric Hospital providers in Missouri →

Registry record

NPI: 1104878792
Entity type: Organization
NPI issued: 16 May 2006
Record last updated: 31 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.