State of Missouri

NPI #1427128164 in Hannibal, Missouri

Provider Information

NPI Number: 1427128164
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: 805 CLINIC RD
City: Hannibal
State: Missouri
ZIP Code: 63401-3611
Phone: (573) 248-2400

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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