STATE OF MISSOURI NPI 1922207679

NPI Information

STATE OF MISSOURI is a community based residential treatment facility, intellectual and/or developmental disabilities in Kansas City, MO. The provider is a home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. STATE OF MISSOURI NPI is 1922207679. The provider is registered as an organization entity type.
The provider Is Doing Business As Esperanza Group Home.

The provider's business location address is:

5410 RINKER RD
KANSAS CITY, MO
ZIP 64129-308
Phone: (816) 512-7515
Fax: (816) 512-7517

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 7/13/2007 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:

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