Organization
MISSOURI SCHOOLS FOR THE SEVERELY DISABLED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ARCHIE DERBOVEN (SUPERINTENDENT)
(573) 751-4427
Entity
Organization
Contact information
Practice address
205 JEFFERSON ST, JEFFERSON CITY, MO 65101-2901
(573) 751-0408
(573) 751-0276
Mailing address
205 JEFFERSON ST, JEFFERSON CITY, MO 65101-2901
(573) 751-0408
(573) 522-9242
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
504852302
—
MO
Enumeration date
02/07/2007
Last updated
09/27/2011
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