Active NPI
State of Missouri
Doing business as Higginsville ISL II
- Developmentally Disabled Services Day Training Agency
- Higginsville, MO
National Provider Identifier
1720140148
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Developmentally Disabled Services Day Training Agency
- License
- EXEMPT
- Legal business name
- STATE OF MISSOURI
- Doing business as
- Higginsville ISL II
- Practice address
- 100 W 1St St
Higginsville, MO 64037 - Phone
- (660) 584-2142
- Fax
- (660) 584-6244
- NPI assigned
- Dec 14, 2006
- Last updated
- Oct 15, 2020
- Organization subpart
- Yes
- Parent organization
- STATE OF MISSOURI
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmentally Disabled Services Day Training Agency | 251C00000X | EXEMPT | MO | Primary |
Addresses
Primary practice location
100 W 1St St
Higginsville, MO 64037
Mailing address
1706 E Elm
Jefferson City, MO 65102-0687
Phone (573) 751-3398
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 851499707 | Medicaid | MO |
Other names 1
- Higginsville ISL II
National Provider Directory
National Provider Directory- Tax ID family
- Western Missouri Mental Health Center
- 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.
-
dba Kirksville Regional Center
- Developmentally Disabled Services Day Training Agency
- Kirksville, MO
- NPI 1578623609
-
dba Southeast Missouri Residential Services-Sikeston
- Intellectual Disabilities Intermediate Care Facility
- Sikeston, MO
- NPI 1598844029
-
dba Southeast Missouri Residential Services ISL
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Poplar Bluff, MO
- NPI 1598906372
-
dba Center for Behavioral Health
- Case Management Agency
- Kansas City, MO
- NPI 1609087584
-
dba Paseo Clinic
- Substance Use Disorder Rehabilitation Clinic/Center
- Kansas City, MO
- NPI 1609954809
-
dba Metropolitan SL PC Pharmcy
- Long Term Care Pharmacy
- Saint Louis, MO
- NPI 1619016862
-
dba Southeast Missouri Mental Health Center Pharmacy
- Institutional Pharmacy
- Farmington, MO
- NPI 1669511093
-
dba Southeast Missouri Mental Health Center
- Case Management Agency
- Farmington, MO
- NPI 1669683439
-
dba Higginsville Habilitation Center
- Intellectual Disabilities Intermediate Care Facility
- Higginsville, MO
- NPI 1689745010
-
dba St Louis Regional Center
- Developmentally Disabled Services Day Training Agency
- Saint Louis, MO
- NPI 1710053780
-
dba Bellefontaine Habilitation Center
- Physical Medicine & Rehabilitation Physician
- Saint Louis, MO
- NPI 1710931167
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166054400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1602720000000",
"number": "1720140148",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1706 E ELM",
"city": "JEFFERSON CITY",
"state": "MO",
"postal_code": "651020687",
"telephone_number": "573-751-3398",
"fax_number": "573-526-4560"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 W 1ST ST",
"city": "HIGGINSVILLE",
"state": "MO",
"postal_code": "64037",
"telephone_number": "660-584-2142",
"fax_number": "660-584-6244"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "STATE OF MISSOURI",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "STATE OF MISSOURI",
"enumeration_date": "2006-12-14",
"last_updated": "2020-10-15",
"certification_date": "2020-10-15",
"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": "251C00000X",
"taxonomy_group": "",
"desc": "Day Training, Developmentally Disabled Services",
"state": "MO",
"license": "EXEMPT",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "851499707",
"state": "MO"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Higginsville ISL II",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Higginsville ISL II",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Higginsville, MO
- Jasbeer Kaur Singh, DDS
- Michelle Ann Sollars-Bosley
- State of Missouri (Higginsville Habilitation Center)
- State of Missouri (Higginsville Habilitation Center-Crisis)
- State of Missouri (Higginsville Habilitation Center)
- Suzanne Strathman, RN, MSN, CPNP
- Andrla Teter, PHARMD
- Marshall Prichard Thompson, LMSW
- Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-0326)
- Vickie Kay Ward, ANP-BC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 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.