Organization
STATE OF MISSOURI
Active
Parent organization
STATE OF MISSOURI
Other names
Nevada 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
1000 N COLORADO ST, NEVADA, MO 64772-1618
(417) 667-7833
(417) 448-1138
Mailing address
1706 E ELM ST, JEFFERSON CITY, MO 65101-4130
(573) 526-6895
(573) 526-6895
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
03/16/2012
Last updated
08/28/2020
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