State of Missouri

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

STATE OF MISSOURI

Doing business as

Ccbho

Practice address

1706 E Elm St
Jefferson City, MO 65101-4130

Phone

(573) 751-3398

NPI assigned

Mar 13, 2020

Organization subpart

Yes

Parent organization

STATE OF MISSOURIAs reported in NPPES

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

Addresses

Other names 1

• CCBHO Doing business as

Tax ID family

Southwest Missouri Psy104 organizations share this tax ID, including this one

Part of

Southwest Missouri Psy

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.

• State of Missouri

  dba Albany Regional Center

  • Case Management Agency
  • Albany, MO
  • NPI 1710056759
  NPD tax ID
• State of Missouri

  dba Bellefontaine Habilitation Center

  • Physical Medicine & Rehabilitation Physician
  • Saint Louis, MO
  • NPI 1710931167
  NPD tax ID
• State of Missouri

  dba Higginsville ISL II

  • Developmentally Disabled Services Day Training Agency
  • Higginsville, MO
  • NPI 1720140148
  NPD tax ID
• State of Missouri

  dba Center for Behavioral Medicine

  • Psychiatric Hospital
  • Kansas City, MO
  • NPI 1730134495
  NPD tax ID
• State of Missouri

  dba Marshall Habilitation Center-Home 4

  • Developmentally Disabled Services Day Training Agency
  • Slater, MO
  • NPI 1730249335
  NPD tax ID
• State of Missouri

  dba Fulton State Hospital

  • Case Management Agency
  • Fulton, MO
  • NPI 1740491539
  NPD tax ID
• State of Missouri

  dba Southeast Missouri Residential Services-Poplar Bluff Prof Grp

  • Family Medicine Physician
  • Poplar Bluff, MO
  • NPI 1740560580
  NPD tax ID
• State of Missouri

  dba Northwest MO PRC Pharmacy

  • Long Term Care Pharmacy
  • Saint Joseph, MO
  • NPI 1750420188
  NPD tax ID
• State of Missouri

  dba Bellefontaine Habilitation Center

  • Intellectual Disabilities Intermediate Care Facility
  • Saint Louis, MO
  • NPI 1760553101
  NPD tax ID
• State of Missouri

  dba Highlands Group Home

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Independence, MO
  • NPI 1760681415
  NPD tax ID
• State of Missouri

  dba Bellefontaine Habilitaion Center-Waiver Services

  • Intellectual Disabilities Intermediate Care Facility
  • Saint Louis, MO
  • NPI 1770866030
  NPD tax ID
• State of Missouri

  dba Rolla Regional Center

  • Developmentally Disabled Services Day Training Agency
  • Rolla, MO
  • NPI 1790851756
  NPD tax ID

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

{
    "created_epoch": "1584057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602720000000",
    "number": "1801422621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 687",
            "address_2": "1706 E ELM ST",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651020687",
            "telephone_number": "573-751-8157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1706 E ELM ST",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651014130",
            "telephone_number": "573-751-3398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF MISSOURI",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "STATE OF MISSOURI",
        "enumeration_date": "2020-03-13",
        "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": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CCBHO",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CCBHO",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• State of Missouri (TCM Youth)
• State of Missouri
• State of Missouri (Division of Youth Services)
• State of Missouri (CPR Adult)
• State of Missouri (CPR Youth)
• State of Missouri (TCM Adult)
• State of Missouri
• Larry K Stauffer, MD
• Laurie Steenbergen, PTA
• Michael G. Steenbergen, M.D.

• Community/Behavioral Health Agency in Jefferson City, MO
• Providers in Jefferson City, MO by specialty
• Community/Behavioral Health Agency in Missouri

• 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.

Verify at the official NPI Registry.