State of Missouri
State of Missouri is an Intellectual Disabilities Intermediate Care Facility in Saint Louis, Missouri. Licensed in Missouri. Registered with an NPI since 2006.
- Licensed in
- MO
- In the registry since
- 2006
Practice location Address checks out
10695 Bellefontaine RdSaint Louis, MO 63137-2315
Phone: (314) 340-6000
Fax: (314) 340-6199
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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 · Licence EXEMPT (MO) |
|---|
Record details
| NPI number | 1760553101 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | Yes |
| Parent organization | State of Missouri |
| Authorized official | Molly Boeckmann — Director Of Administrative Services · (573) 751-4055 |
| Other names | Bellefontaine Habilitation Center; Bellefontaine Habilitation Center |
| NPI enumerated | November 9, 2006 |
| Last updated in NPPES | October 20, 2020 |
| Certification date | October 20, 2020 |
| Mailing address | Po Box 687, Jefferson City, MO 65102-0687 |
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State of Missouri
10695 Bellefontaine Rd, Saint Louis, MO 63137-2315 · (314) 340-6000