Organization · Type 2 NPI

State of Missouri

Psychiatric Hospital · St. Joseph, MO

NPI number 1104879444 Active

Practice location

3505 Frederick Ave
St. Joseph, MO 64506-2914

Call (816) 387-2300 Map

Fax (816) 387-2329

Mailing address

PO Box 687
Jefferson City, MO 65102-0687

Specialties and licenses

Taxonomy	Code	License
Psychiatric Hospital Primary	283Q00000X	EXEMPT (MO)

Psychiatric Hospital: 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.

27 other providers at this address

NPI record

NPI: 1104879444
Entity type: Organization (Type 2)
Issued: May 18, 2006
Last updated: Oct 27, 2020
Status: Active
Subpart: Yes of State of Missouri

Other names

<unavail>
Northwest Mo Psychiatric Rehabilitation Center · doing business as
Northwest Mo Psychiatric Rehabilitation Center · doing business as

Authorized official

Molly Jane Boeckmann
Director of Administrative Services
(573) 751-4055

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1104879444

State of Missouri's National Provider Identifier is 1104879444, issued on May 18, 2006. The primary taxonomy on file is Psychiatric Hospital (283Q00000X), and the practice location is in St. Joseph, MO. The record was last updated on Oct 27, 2020.