STATE OF MISSOURI

Intermediate Care Facility, Intellectual Disabilities

Active Organization
NPI: 1164630463

Practice Address

11 BRADY CIR
Overland, MO 63114

Phone: (314) 428-8470

Specialties

Specialty Code Primary License
Intermediate Care Facility, Intellectual Disabilities 315P00000X Yes -

Frequently Asked Questions

NPI 1164630463 is the National Provider Identifier for STATE OF MISSOURI, a Intermediate Care Facility, Intellectual Disabilities provider located in Overland, MO. This NPI was enumerated on May 18, 2007.

Quick Facts

NPI
1164630463
Type
Organization
Enumerated
May 18, 2007
Last Updated
Oct 27, 2020

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