Organization Active NPI

State of Missouri

Doing business as Nevada Habilitation Center-Crisis

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Nevada, MO
National Provider Identifier
1528333085
Registry record updated Aug 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
Legal business name
STATE OF MISSOURI
Doing business as
Nevada Habilitation Center-Crisis
Practice address
1000 N Colorado St
Nevada, MO 64772-1618
Phone
(417) 667-7833
Fax
(417) 448-1138
NPI assigned
Mar 16, 2012
Last updated
Aug 28, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
STATE OF MISSOURIAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 28, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Molly Jane Boeckmann
Title
Director of Administrative Services
Phone
(573) 751-4055

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X Primary

Addresses

Primary practice location

1000 N Colorado St
Nevada, MO 64772-1618

Mailing address

1706 E Elm St
Jefferson City, MO 65101-4130
Phone (573) 526-6895

Other names 1

  • Nevada Habilitation Center-Crisis Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Western Missouri Mental Health Center104 organizations share this tax ID, including this one
Part of
Western Missouri Mental Health Center

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1331856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598572800000",
    "number": "1528333085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1706 E ELM ST",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651014130",
            "telephone_number": "573-526-6895",
            "fax_number": "573-526-6895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 N COLORADO ST",
            "city": "NEVADA",
            "state": "MO",
            "postal_code": "647721618",
            "telephone_number": "417-667-7833",
            "fax_number": "417-448-1138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF MISSOURI",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "STATE OF MISSOURI",
        "enumeration_date": "2012-03-16",
        "last_updated": "2020-08-28",
        "certification_date": "2020-08-28",
        "status": "A",
        "authorized_official_last_name": "BOECKMANN",
        "authorized_official_first_name": "MOLLY",
        "authorized_official_middle_name": "JANE",
        "authorized_official_title_or_position": "DIRECTOR OF ADMINISTRATIVE SERVICES",
        "authorized_official_telephone_number": "573-751-4055"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nevada Habilitation Center-Crisis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Nevada Habilitation Center-Crisis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Nevada, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.