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State Of Missouri
Intellectual Disabilities Intermediate Care Facility in Overland, Missouri
NPI 1164630463

State Of Missouri is a Intellectual Disabilities Intermediate Care Facility based in Jefferson City, MO. State Of Missouri practices in Overland, MO. The NPI Number for State Of Missouri is 1164630463 and holds a License No. (Missouri).

The current practice location address for State Of Missouri is 11 Brady Cir, Overland, MO and can be reached out via phone at 314-428-8470.

Location: 11 Brady Cir, Overland, MO, 65101-4130
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1164630463
Provider Name
State Of Missouri
Credential
Provider Entity Type
Organization
Address
11 Brady Cir, Overland, MO, 65101-4130
Phone Number
314-428-8470
Fax Number
Provider Enumeration Date
05/18/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
052361904 05 MO
institution
Provider Business Practice Location Address Details
Address
11 Brady Cir
City
Overland
State
Missouri
Zip
63114-1110
Phone Number
314-428-8470
Fax Number
person
Provider Business Mailing Address Details
Address
11 Brady Cir
City
Overland
State
Missouri
Zip
63114-1110
Phone Number
314-428-8470
Fax Number
person
Provider's Taxonomy Details 1
Type
Nursing & Custodial Care Facilities
Classification
Intermediate Care Facility, Mentally Retarded
Speciality
-
Taxonomy
315P00000X
License No.
()
Definition
(1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals.
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