NPI 1689745010
State of Missouri
Practice location
- Address
- 100 W 1st St, Higginsville, MO 64037-1171
- Phone
- (660) 584-2142
- Fax
- (660) 584-6244
- Mailing address
- PO Box 687, Jefferson City, MO 65102-0687
Authorised official
- Name
- Molly Jane Boeckmann
- Title
- Director of Administrative Services
- Phone
- (573) 751-4055
Registered specialties
Intellectual Disabilities Intermediate Care Facility
Primary
Registry record
- NPI
- 1689745010
- Entity type
- Organization
- NPI issued
- 9 Nov 2006
- Record last updated
- 27 Oct 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.