STATE OF MISSOURI


Address: 1301 Industrial Pkwy E, El Dorado Springs, MO 64744-6263
Phone: 4178761002

STATE OF MISSOURI (NPI# 1952356610) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1952356610
Entity Type Organization
Organization Name STATE OF MISSOURI
Other Organization Name SOUTHWEST MISSOURI PSYCHIATRIC REHABILITATION CENTER
Practice Address 1301 Industrial Pkwy E
El Dorado Springs
MO 64744-6263
Mailing Address 1706 E Elm St
Jefferson City
MO 65101-4130
Practice Telephone 4178761002
Practice Fax Number 4178761004
Mailing Telephone 5737513398
Mailing Fax Number 5735264560
Enumeration Date 2006-05-23
Last Update Date 2020-10-27
Authorized Official Name MOLLY JANE BOECKMANN (DIRECTOR OF ADMINISTRATIVE SERVICES)
Authorized Official Telephone 5737514055
Is Organization Subpart Y
Parent Organization Name STATE OF MISSOURI

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 283Q00000X Psychiatric Hospital Hospitals

Other Provider Identifier

State Issuer Identifier Type Code
MO 021499900 05

Other Provider/Organization Names

Other Name Type Code
Southwest Missouri Psychiatric Rehabilitation Center Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1437781499 State of Missouri Rehabilitation Counselor 3418 Knipp Dr, Jefferson City, MO 65109-5701 2020-02-07
1275073280 State of Missouri General Practice 1547 W Commerce Drive, Marshall, MO 65340-3907 2017-02-24
1528333085 State of Missouri Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 1000 N Colorado St, Nevada, MO 64772-1618 2012-03-16
1386843621 State of Missouri Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 15555 Little Blue Rd, Kansas City, MO 64139 2007-07-17
1922207679 State of Missouri Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 5410 Rinker Rd, Kansas City, MO 64129-2308 2007-07-13
1760681415 State of Missouri Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 1501 N River Blvd, Independence, MO 64050-1760 2007-07-13
1164630463 State of Missouri Intermediate Care Facility, Mentally Retarded 11 Brady Cir, Overland, MO 63114-1110 2007-05-18
1548322605 State of Missouri Day Training, Developmentally Disabled Services 1500 Vandiver Dr Ste 100, Columbia, MO 65202-3932 2006-12-15
1366503153 State of Missouri Day Training, Developmentally Disabled Services 471 E Slater St, Marshall, MO 65340 2006-12-13
1427118033 State of Missouri Day Training, Developmentally Disabled Services 522 Star St, Marshall, MO 65340 2006-12-12

Office Location

Street Address 1301 INDUSTRIAL PKWY E
City EL DORADO SPRINGS
State MO
Zip Code 64744-6263

Providers in the same location

NPI Name Taxonomy Address Enumeration
1396798237 State of Missouri Social Worker 1301 Industrial Pkwy E, El Dorado Springs, MO 64744-6263 2006-05-19
1801338991 Ashley N Daniels Social Worker 1301 Industrial Pkwy E, El Dorado Springs, MO 64744-6263 2016-11-07
1922406545 Kimberly C Tipton Registered Nurse 1301 Industrial Pkwy E, El Dorado Springs, MO 64744-6263 2014-12-13
1780080283 Sharon Ann Foreman Registered Nurse 1301 Industrial Pkwy E, El Dorado Springs, MO 64744-6263 2014-11-10
1003212606 Wilmer Sebastion Roll Licensed Practical Nurse 1301 Industrial Pkwy E, El Dorado Springs, MO 64744-6263 2014-11-08
1326334087 Marie T Conner Clinical Nurse Specialist 1301 Industrial Pkwy E, El Dorado Springs, MO 64744-6263 2011-06-21
1194936971 State of Missouri Case Management 1301 Industrial Pkwy E, El Dorado Springs, MO 64744-6263 2007-05-24

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1295251742 Rachel Kauffman Pharmacist 1403 S. Park St., El Dorado Springs, MO 64744 2017-08-16
1457898603 Stephanie Louise Miller Nurse Practitioner 322 E Hospital Rd, El Dorado Springs, MO 64744 2017-01-26
1902200645 Kimberly Denise Souza Nurse Practitioner 1317 South Hwy. 32, El Dorado Springs, MO 64744 2014-10-09
1376843714 Sandra Jeanne Moore Registered Nurse 107 W Broadway, Pathway's Behavioral Health Care, Eldorado Springs, MO 64744 2010-11-02
1275674715 Michael Lee Housh Dentist 605 E Hospital Road, Suite #1, El Dorado Springs, MO 64744 2007-02-09
1932269446 State of Missouri Case Management 1301 Industrial Prkwy E, El Dorado Springs, MO 64744 2006-12-12
1720195845 Wilkinson Pharmacy Inc Pharmacy 200 E Hwy 54, El Dorado Springs, MO 64744 2006-08-24
1881608685 Cedar County Memorial Hospital Clinic/Center 1317 S. Highway 32, El Dorado Springs, MO 64744 2006-07-28
1942243639 Todd P. Hill Dentist 107 Broadway Street, El Dorado Springs, MO 64744 2006-06-13
1902379266 El Dorado Vision LLC Optometrist 701 E Hospital Rd, El Dorado Springs, MO 64744 2019-01-09
Find all providers in zip 64744

Taxonomy Information

Taxonomy Code 283Q00000X
Grouping Hospitals
Classification Psychiatric Hospital

Taxonomy Definition

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.
Notes: Source: Expanded from Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988.

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1700485281 Cape Girardeau Behavioral Health LLC Psychiatric Hospital 639 S Silver Springs Rd, Cape Girardeau, MO 63703-7539 2020-10-26
1760973044 Centerpointe Hospital of Columbia, LLC Psychiatric Hospital 1201 International Drive, Columbia, MO 65202 2018-05-23
1790115939 Nhc Reliant Psychiatric Services LLC Psychiatric Hospital 840 Passover Road, Osage Beach, MO 65065-2834 2013-11-26
1649518382 Comc Psychiatric Hospital 5260 S Tanager Ave, Battlefield, MO 65619-9222 2013-01-30
1528340841 St. Louis Regional Psychiatric Stabilization Center Psychiatric Hospital 5355 Delmar Boulevard, St. Louis, MO 63112-3146 2011-09-13
1750692638 Global Psychiatric Associates Inc Psychiatric Hospital 16216 Baxter Rd Ste 323, Chesterfield, MO 63017-4778 2010-06-25
1346485257 Western Missouri Mental Health Psychiatric Hospital 1000 E. 24th Street, Kansas City, MO 64108 2008-12-05
1558541755 Marie E (melissa) Ring Psychiatric Hospital 1010 West Columbia, Farmington, MO 63640 2007-11-06
1033289897 State of Missouri Psychiatric Hospital 1901 Pennsylvania Ave, Saint Louis, MO 63133-1325 2006-11-09
1497795892 Midwest Division - Rpc, LLC Psychiatric Hospital 2323 E 63rd St, Kansas City, MO 64130-3462 2006-06-07
Find all providers with the same taxonomy

Competitor

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City EL DORADO SPRINGS
Zip Code 64744

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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