State of Missouri

NPI #1407926140 in Rolla, Missouri

Provider Information

NPI Number: 1407926140
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: 105 FAIRGROUNDS RD
City: Rolla
State: Missouri
ZIP Code: 65401-2909
Phone: (573) 368-2200

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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