NPI 1992913297

State of Missouri

Organisation Intellectual Disabilities Intermediate Care Facility Saint Charles, MO

Practice location

Address: 22 Marr Ln, Saint Charles, MO 63303-9000
Phone: (636) 926-1300
Mailing address: 1706 E Elm St, Jefferson City, MO 65101-4130

Authorised official

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

Registered specialties

Intellectual Disabilities Intermediate Care Facility Primary

Nursing & Custodial Care Facilities Taxonomy 315P00000X

Other Intermediate Care Facility, Intellectual Disabilities providers in Missouri →

Registry record

NPI: 1992913297
Entity type: Organization
NPI issued: 18 May 2007
Record last updated: 26 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.