Cottonwood Residential Treatment Center

LBN: State Of Missouri
Cottonwood Residential Treatment Center is an health care organization with primary practice located at 1025 N Sprigg St , Cape Girardeau MO 63701-4831. The organization recently has only one registered license in Residential Treatment Facilities / Psychiatric Residential Treatment Facility, which is considered as the primary health care specialty. State Of Missouri can be contacted via phone (573) 290-5888, or through Boeckmann, Molly Jane via phone (573) 751-4055.

Contact Information

Primary practice address
1025 N Sprigg St Cape Girardeau MO 63701-4831
Phone: (573) 290-5888
Fax: (573) 290-5895
Website:
Map and Directions
Authorized official contact:
Name: Boeckmann, Molly Jane
Phone: (573) 751-4055

Health care specialties

SpecialtyCodeLicense #State
Residential Treatment Facilities / Psychiatric Residential Treatment Facility 323P00000X EXEMPT Missouri

Profile Details

NPI number 1013096544
LBN Legal business name State Of Missouri
DBA Doing business as Cottonwood Residential Treatment Center
Authorized official Boeckmann, Molly Jane
Entity Organization
Organization subpart 1 Yes
Enumeration date Nov 3rd, 2006
Last updated Aug 28th, 2020 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1013096544 NPPES
Missouri MEDICAID 053445003
Missouri MEDICAID 873445001

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