Provider Type Icon

STATE OF MISSOURI NPI 1952356610


NPI Information

NPI: 1952356610
Provider Name: STATE OF MISSOURI

Doing Business As: SOUTHWEST MISSOURI PSYCHIATRIC REHABILITATION CENTER

Classification: Psychiatric Hospital - 283Q00000X
Entity Type: Organization
Address:
1301 INDUSTRIAL PKWY E
EL DORADO SPRINGS, MO
ZIP 64744
Phone: (417) 876-1002
Get Directions

STATE OF MISSOURI is a psychiatric hospital in El Dorado Springs, MO. The provider is an organization including a physical plant and personnel that provides multidisciplinary diagnostic and treatment mental health services to patients requiring the safety, security, and shelter of the inpatient or partial hospitalization settings. STATE OF MISSOURI NPI is 1952356610. The provider is registered as an organization entity type.
The provider Is Doing Business As Southwest Missouri Psychiatric Rehabilitation Center.

The provider's business location address is:

1301 INDUSTRIAL PKWY E
EL DORADO SPRINGS, MO
ZIP 64744-263
Phone: (417) 876-1002
Fax: (417) 876-1004

The provider's authorized official is Molly Jane Boeckmann .
The authorized official title is Director Of Administrative Services and has the following contact phone number (573) 751-4055.

The enumeration date for this NPI number is 5/23/2006 and was last updated on 10/27/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1283Q00000XPsychiatric HospitalYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1021499900MEDICAIDMISSOURI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.