Organization
STATE OF MISSOURI
Active
Parent organization
STATE OF MISSOURI
Other names
Higginsville Habilitation Center-Crisis
Organization subpart
Yes
Provider details
NPI number
Legal business name
STATE OF MISSOURI
Authorized official
MOLLY JANE BOECKMANN (DIRECTOR OF ADMINISTRATIVE SERVICES)
(573) 751-4055
Entity
Organization
Contact information
Practice address
100 W 1ST ST, HIGGINSVILLE, MO 64037-1171
(660) 584-2142
(660) 584-6244
Mailing address
1706 E ELM ST ATTN REIMBURSEMENTS, PO BOX 687, JEFFERSON CITY, MO 65102-0687
(573) 751-3398
(573) 526-4560
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
11/07/2011
Last updated
08/28/2020
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