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

State of Missouri

Organization Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · NPI 1942442702

State of Missouri is an Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Saint Louis, Missouri. Registered with an NPI since 2009.

In the registry since
2009
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Practice location Address checks out

11 Brady Cir
Saint Louis, MO 63114-1110
Phone: (314) 877-1624
Fax: (314) 877-5666
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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 number1942442702
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationState of Missouri
Authorized official Molly Boeckmann — Director Of Administrative Services · (573) 751-4055
Other names St. Louis Developmental Disabilities Treatment Center Isl; St. Louis Developmental Disabilities Treatment Center Isl
NPI enumeratedMarch 25, 2009
Last updated in NPPESAugust 28, 2020
Certification dateAugust 28, 2020
Mailing address1706 E Elm St, Jefferson City, MO 65101-4130

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