Organization · Type 2 NPI

State of Missouri

Intellectual Disabilities Intermediate Care Facility · Higginsville, MO

NPI number 1689745010 Active

Practice location

100 W 1st St
Higginsville, MO 64037-1171

Call (660) 584-2142 Map

Fax (660) 584-6244

Mailing address

PO Box 687
Jefferson City, MO 65102-0687

Specialties and licenses

Taxonomy	Code	License
Intellectual Disabilities Intermediate Care Facility Primary	315P00000X	EXEMPT (MO)

Intellectual Disabilities Intermediate Care Facility: An intermediate care facility providing services for individuals with intellectual disabilities.

5 other providers at this address

Other intellectual disabilities intermediate care facility providers in Higginsville

Progressive Alternative Living, Inc.Intellectual Disabilities Intermediate Care Facility Higginsville, MO NPI 1093981052

See all in Higginsville →

NPI record

NPI: 1689745010
Entity type: Organization (Type 2)
Issued: Nov 9, 2006
Last updated: Oct 27, 2020
Status: Active
Subpart: Yes of State of Missouri

Other names

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Higginsville Habilitation Center · doing business as
Higginsville Habilitation 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 1689745010

State of Missouri's National Provider Identifier is 1689745010, issued on Nov 9, 2006. The primary taxonomy on file is Intellectual Disabilities Intermediate Care Facility (315P00000X), and the practice location is in Higginsville, MO. The record was last updated on Oct 27, 2020.