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Contact Information

STATE OF MISSOURI
809 N 13TH ST
ALBANY, MO64402
 Phone: 660-726-5426
 Fax: 660-726-5165
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Day Training, Developmentally Disabled Services

251C00000X
Indicates primary specialty

NPI Profile & details for STATE OF MISSOURI

NPI # 1245391028
LBN Legal business name STATE OF MISSOURI
Authorized official MOLLY BOECKMANN - (DIRECTOR OF ADMINISTRATIVE SERVICES)
Entity Organization
Organization subpart 1 Yes
Enumeration date 12/13/2006
Last updated 08/28/2020 - About 6 years ago
Identifiers
MO License # EXEMPT
MO Medicaid 851792408
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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