State of Missouri
State of Missouri is an Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Independence, Missouri. Registered with an NPI since 2007.
- In the registry since
- 2007
Practice location Address checks out
1501 N River BlvdIndependence, MO 64050-1760
Phone: (816) 512-7515
Fax: (816) 512-7517
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (primary) | Taxonomy 320900000X |
|---|
Record details
| NPI number | 1760681415 |
|---|---|
| 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 | Highlands Group Home; Highlands Group Home |
| NPI enumerated | July 13, 2007 |
| Last updated in NPPES | October 20, 2020 |
| Certification date | October 20, 2020 |
| Mailing address | 1706 E Elm St, Jefferson City, MO 65101-4130 |
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