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Organization
SSM REGIONAL HEALTH SERVICES
Active
Organization
SSM REGIONAL HEALTH SERVICES
Active
Parent organization
SSM REGIONAL HEALTH SERVICES
Other names
SSM Health Medical Group - Behavioral Health
Organization subpart
Yes
Provider details
NPI number
Legal business name
SSM REGIONAL HEALTH SERVICES
Authorized official
SHASTA RENE MANUEL (REGIONAL VICE PRESIDENT FINANCE/CFO)
(405) 272-7282
Entity
Organization
Contact information
Practice address
2701 WEST EDGEWOOD, SUITE 101, JEFFERSON CITY, MO 65109
(573) 634-5303
(573) 761-6888
Mailing address
7655 SOLUTIONS CTR, CHICAGO, IL 60677-7006
(557) 203-1551
(314) 989-6721
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
502680002
—
MO
Enumeration date
05/27/2006
Last updated
12/16/2025
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