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State Of Missouri

State Of Missouri is a health care provider in Jefferson City, MO. In this page you will find its mailing address, practice location, phone number, specialty etc.

physician-icon Basic Information

Practice Location 1301 Industrial Prkwy E, El Dorado Springs, MO 64744, US
Practice Location Phone417-876-1002
Practice Location Fax417-876-1004
Legal Business NameSTATE OF MISSOURI
Other Organization NameSOUTHWEST MISSOURI PSYCHIATRIC REHABILITIATION CENTER
Other Organization Name TypeDoing Business As Name
NPI ?1932269446
Entity TypeOrganization
Enumeration Date ? Dec 12, 2006
Last Update Date ? Dec 15, 2010
Note:
NPI: National Provider Identifier issued to health care providers by Centers for Medicare and Medicaid Services (CMS).

specialty-icon Specialties & Licenses of State Of Missouri

SpecialtySpecializationLicenseLicense State
Case Management

legacy-id-icon Legacy Provider IDs of State Of Missouri

Provider IdIssuer StateIssuer TypeIssuer
156175200MissouriMedicaid

official-icon Authorized Official of State Of Missouri

An authorized official is an appointed official with the legal authority to make changes and/or updates to the State Of Missouri's status and to commit the provider to fully abide by the laws and regulations relating to the National Provider Identifier (NPI).

Authorized Official Brent Mcginty
Authorized Official Title/PositionDMH DIRECTOR OF ADMINISTRATION
Authorized Official Phone Number573-751-8144