Organization
STATE OF MISSOURI
Active
Parent organization
STATE OF MISSOURI
Other names
Esperanza Group Home
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
5410 RINKER RD, KANSAS CITY, MO 64129-2308
(816) 512-7515
(816) 512-7517
Mailing address
1706 E ELM ST, JEFFERSON CITY, MO 65101-4130
(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
07/13/2007
Last updated
10/27/2020
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