STATE OF MISSOURI NPI 1609954809

NPI Information

NPI: 1609954809
Provider Name: STATE OF MISSOURI

Doing Business As: PASEO CLINIC

Classification: Clinic/Center - 261QR0405X
Entity Type: Organization

Specialization: Rehabilitation, Substance Use Disorder

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

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
1	261QR0405X	Clinic/Center	Rehabilitation, Substance Use Disorder	EXEMPT	MISSOURI	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	866205800	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: 4/28/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »