State of Missouri

NPI #1790851756 in Rolla, Missouri

Provider Information

NPI Number
1790851756
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
Nov 28, 2006
Last Updated
Oct 15, 2020

Practice Location

Address
105 FAIRGROUNDS RD
City
Rolla
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
Day Training, Developmentally Disabled Services

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