State of Missouri

NPI #1487714515 in Hannibal, Missouri

Provider Information

NPI Number
1487714515
Entity Type
Organization
Organization Name
State of Missouri
Subpart
Yes (part of a larger organization)
Parent Organization
STATE OF MISSOURI
Primary Specialty
Day Training, Developmentally Disabled Services
Enumeration Date
Dec 11, 2006
Last Updated
Oct 20, 2020

Practice Location

Address
805 CLINIC RD
ZIP Code
63401
Phone
(573) 248-2400

Authorized Official

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

Specialties & Taxonomy Codes

Specialty
Day Training, Developmentally Disabled Services

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