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State Of Missouri
Intellectual Disabilities Intermediate Care Facility in Marshall, Missouri
NPI 1861563298

State Of Missouri is a Intellectual Disabilities Intermediate Care Facility based in Jefferson City, MO. State Of Missouri practices in Marshall, MO. The NPI Number for State Of Missouri is 1861563298 and holds a License No. EXEMPT (Missouri).

The current practice location address for State Of Missouri is 700 E Slater St, Marshall, MO and can be reached out via phone at 660-886-2201 and via fax at 660-831-3071.

Location: 700 E Slater St, Marshall, MO, 65102-0687
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1861563298
Provider Name
State Of Missouri
Credential
Provider Entity Type
Organization
Address
700 E Slater St, Marshall, MO, 65102-0687
Phone Number
660-886-2201
Fax Number
660-831-3071
Provider Enumeration Date
11/09/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
051499804 05 MO
institution
Provider Business Practice Location Address Details
Address
700 E Slater St
City
Marshall
State
Missouri
Zip
65340-1240
Phone Number
660-886-2201
Fax Number
660-831-3071
person
Provider Business Mailing Address Details
Address
700 E Slater St
City
Marshall
State
Missouri
Zip
65340-1240
Phone Number
660-886-2201
Fax Number
660-831-3071
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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