State of Missouri

NPI #1316017056 in Sikeston, Missouri

Provider Information

NPI Number
1316017056
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 20, 2020

Practice Location

Address
112 PLAZA DR
ZIP Code
63801-5137
Phone
(573) 472-5300

Authorized Official

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

Specialties & Taxonomy Codes

Specialty
Case Management

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