Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

State of Missouri

Organization Intellectual Disabilities Intermediate Care Facility · NPI 1164630463

State of Missouri is an Intellectual Disabilities Intermediate Care Facility in Overland, Missouri. Registered with an NPI since 2007.

In the registry since
2007
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Practice location Address checks out

11 Brady Cir
Overland, MO 63114-1110
Phone: (314) 428-8470
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Intellectual Disabilities Intermediate Care Facility (primary) Taxonomy 315P00000X

Record details

NPI number1164630463
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationState of Missouri
Authorized official Molly Boeckmann — Director Of Administrative Services · (573) 751-4055
Other names North West Habilitation Center; North West Habilitation Center
NPI enumeratedMay 18, 2007
Last updated in NPPESOctober 27, 2020
Certification dateOctober 27, 2020
Mailing address1706 E Elm St, Jefferson City, MO 65101-4130