State of Missouri

NPI #1275603920 in Columbia, Missouri

Provider Information

NPI Number: 1275603920
Entity Type: Organization
Organization Name: State of Missouri
Subpart: Yes (part of a larger organization)
Parent Organization: STATE OF MISSOURI
Primary Specialty: Case Management
Enumeration Date: Nov 9, 2006
Last Updated: Oct 27, 2020

Practice Location

Address: 1500 VANDIVER DR
Address 2: SUITE 100
City: Columbia
State: Missouri
ZIP Code: 65202-3932
Phone: (573) 882-9835

Authorized Official

Name: MOLLY JANE BOECKMANN
Title: DIRECTOR OF ADMINISTRATIVE SERVICES
Phone: (573) 751-4055

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Case Management	251B00000X	Primary

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