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).
| 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 |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 283Q00000X | Psychiatric Hospital | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 021499900 | 05 |
| Other Name | Type Code |
|---|---|
| Southwest Missouri Psychiatric Rehabilitation Center | Doing Business As Name - Organization |
| 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 |
| Street Address |
1301 INDUSTRIAL PKWY E |
| City | EL DORADO SPRINGS |
| State | MO |
| Zip Code | 64744-6263 |
| 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 |
| 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 Code | 283Q00000X |
| Grouping | Hospitals |
| Classification | 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. |
| Notes: Source: Expanded from Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| 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 | ||||
| City | EL DORADO SPRINGS |
| Zip Code | 64744 |
Please comment or provide details below to improve the information on STATE OF MISSOURI.
| 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.