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State Of Missouri
Intellectual Disabilities Intermediate Care Facility in Higginsville, Missouri
NPI 1689745010

State Of Missouri is a Intellectual Disabilities Intermediate Care Facility based in Jefferson City, MO. State Of Missouri practices in Higginsville, MO. The NPI Number for State Of Missouri is 1689745010 and holds a License No. EXEMPT (Missouri).

The current practice location address for State Of Missouri is 100 W 1St St, Higginsville, MO and can be reached out via phone at 660-584-2142 and via fax at 660-584-6244.

Location: 100 W 1St St, Higginsville, MO, 65102-0687
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1689745010
Provider Name
State Of Missouri
Credential
Provider Entity Type
Organization
Address
100 W 1St St, Higginsville, MO, 65102-0687
Phone Number
660-584-2142
Fax Number
660-584-6244
Provider Enumeration Date
11/09/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
051499705 05 MO
institution
Provider Business Practice Location Address Details
Address
100 W 1St St
City
Higginsville
State
Missouri
Zip
64037-1171
Phone Number
660-584-2142
Fax Number
660-584-6244
person
Provider Business Mailing Address Details
Address
100 W 1St St
City
Higginsville
State
Missouri
Zip
64037-1171
Phone Number
660-584-2142
Fax Number
660-584-6244
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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