State of Missouri
NPI #1013096544 in Cape Girardeau, Missouri
Provider Information
- NPI Number
- 1013096544
- Entity Type
- Organization
- Organization Name
- State of Missouri
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- STATE OF MISSOURI
- Primary Specialty
- Psychiatric Residential Treatment Facility
- Enumeration Date
- Nov 3, 2006
- Last Updated
- Aug 28, 2020
Practice Location
- Address
- 1025 N SPRIGG ST
- City
- Cape Girardeau
- State
- Missouri
- ZIP Code
- 63701-4831
- Phone
- (573) 290-5888
Authorized Official
- Name
- MOLLY JANE BOECKMANN
- Title
- DIRECTOR OF ADMINSTRATIVE SERVICES
- Phone
- (573) 751-4055
Specialties & Taxonomy Codes
| Specialty |
|---|
| Psychiatric Residential Treatment Facility |
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