STATE OF MISSOURI NPI 1609954809

NPI Information

  • NPI: 1609954809
  • Provider Name: STATE OF MISSOURI
  • Classification: Clinic/Center - 261QR0405X
  • Specialization: Rehabilitation, Substance Use Disorder
  • Entity Type: Organization
  • Doing Business As: PASEO CLINIC
  • Address: 1000 E 24TH ST
    KANSAS CITY, MO
    ZIP 64108
  • Phone: (816) 512-7143

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NPI Details

STATE OF MISSOURI is a rehabilitation and substance use disorder clinic center in Kansas City, MO. STATE OF MISSOURI NPI is 1609954809. The provider is registered as an organization entity type.
The provider Is Doing Business As Paseo Clinic.

The provider's business location address is:

1000 E 24TH ST
KANSAS CITY, MO
ZIP 64108-776
Phone: (816) 512-7143

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 11/2/2006 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
1261QR0405XClinic/CenterRehabilitation, Substance Use DisorderEXEMPTMISSOURIYes

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
1866205800MEDICAIDMISSOURI

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: 11/21/2025

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