STATE OF MISSOURI is an intermediate care facility mentally retarded in Saint Louis, MO. The provider is (1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals. STATE OF MISSOURI NPI is 1194933499. The provider is registered as an organization entity type.
The provider Is Doing Business As South County Habilitation Center.
The provider's business location address is:
2312 LEMAY FERRY RD
SAINT LOUIS, MO
ZIP 63125-127
Phone: (314) 894-5400
The provider's authorized official is Molly Jane Boeckmann .
The authorized official title is Director Of Administrative Services and has the following contact phone number (573) 751-4055.
The enumeration date for this NPI number is 5/18/2007 and was last updated on 8/26/2020.