Organization · Type 2 NPI

State of Missouri

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Higginsville, MO

NPI number 1487931358 Active

Practice location

100 W 1st St
Higginsville, MO 64037-1171

Call (660) 584-2142 Map

Fax (660) 584-6244

Mailing address

1706 E Elm St Attn Reimbursements, PO Box 687
Jefferson City, MO 65102-0687

Specialties and licenses

Taxonomy	Code	License
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary	320900000X	None listed

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility: A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.

5 other providers at this address

Other intellectual and/or developmental disabilities community based residential treatment facility providers in Higginsville

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NPI record

NPI: 1487931358
Entity type: Organization (Type 2)
Issued: Nov 7, 2011
Last updated: Aug 28, 2020
Status: Active
Subpart: Yes of State of Missouri

Other names

<unavail>
Higginsville Habilitation Center-Crisis · doing business as
Higginsville Habilitation Center-Crisis · doing business as

Authorized official

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

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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 1487931358

State of Missouri's National Provider Identifier is 1487931358, issued on Nov 7, 2011. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (320900000X), and the practice location is in Higginsville, MO. The record was last updated on Aug 28, 2020.