State of Missouri
NPI #1609954809 in Kansas City, Missouri
Provider Information
- NPI Number
- 1609954809
- Entity Type
- Organization
- Organization Name
- State of Missouri
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- STATE OF MISSOURI
- Primary Specialty
- Clinic/Center - Rehabilitation, Substance Use Disorder
- Enumeration Date
- Nov 2, 2006
- Last Updated
- Oct 27, 2020
Practice Location
- Address
- 1000 E 24TH ST
- City
- Kansas City
- State
- Missouri
- ZIP Code
- 64108-2776
- Phone
- (816) 512-7143
Authorized Official
- Name
- MOLLY JANE BOECKMANN
- Title
- DIRECTOR OF ADMINISTRATIVE SERVICES
- Phone
- (573) 751-4055
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Rehabilitation, Substance Use Disorder — Rehabilitation, Substance Use Disorder |
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