STATE OF MISSOURI NPI 1407803851

NPI Information

NPI: 1407803851
Provider Name: STATE OF MISSOURI

Doing Business As: HIGGINSVILLE HABILITATION CENTER

Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
100 WEST 1ST ST
HIGGINSVILLE, MO
ZIP 64037
Phone: (660) 584-2142
Get Directions

STATE OF MISSOURI is a family medicine in Higginsville, MO. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. STATE OF MISSOURI NPI is 1407803851. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Higginsville Habilitation Center.

The provider's business location address is:

100 WEST 1ST ST
HIGGINSVILLE, MO
ZIP 64037
Phone: (660) 584-2142
Fax: (660) 584-6244

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 5/30/2006 and was last updated on 10/27/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2084P0800X	Psychiatry & Neurology	Psychiatry			No
2	207Q00000X	Family Medicine				Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	501499701	MEDICAID	MISSOURI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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