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State Of Missouri
Intellectual Disabilities Intermediate Care Facility in Sikeston, Missouri
NPI 1598844029

State Of Missouri is a Intellectual Disabilities Intermediate Care Facility based in Jefferson City, MO. State Of Missouri practices in Sikeston, MO. The NPI Number for State Of Missouri is 1598844029 and holds a License No. EXEMPT (Missouri).

The current practice location address for State Of Missouri is 112 Plaza Dr, Sikeston, MO and can be reached out via phone at 573-472-5300 and via fax at 573-472-5308.

Location: 112 Plaza Dr, Sikeston, MO, 65102-0687
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1598844029
Provider Name
State Of Missouri
Credential
Provider Entity Type
Organization
Address
112 Plaza Dr, Sikeston, MO, 65102-0687
Phone Number
573-472-5300
Fax Number
573-472-5308
Provider Enumeration Date
11/03/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
051793206 05 MO
institution
Provider Business Practice Location Address Details
Address
112 Plaza Dr
City
Sikeston
State
Missouri
Zip
63801-5137
Phone Number
573-472-5300
Fax Number
573-472-5308
person
Provider Business Mailing Address Details
Address
112 Plaza Dr
City
Sikeston
State
Missouri
Zip
63801-5137
Phone Number
573-472-5300
Fax Number
573-472-5308
person
Provider's Taxonomy Details 1
Type
Nursing & Custodial Care Facilities
Classification
Intermediate Care Facility, Mentally Retarded
Speciality
-
Taxonomy
315P00000X
License No.
EXEMPT (Missouri)
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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