South County Habilitation Center

LBN: State Of Missouri
South County Habilitation Center is an health care organization with primary practice located at 2312 Lemay Ferry Rd , Saint Louis MO 63125-3127. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded, which is considered as the primary health care specialty. State Of Missouri can be contacted via phone (314) 894-5400, or through Boeckmann, Molly Jane via phone (573) 751-4055.

Contact Information

Primary practice address
2312 Lemay Ferry Rd Saint Louis MO 63125-3127
Phone: (314) 894-5400
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Boeckmann, Molly Jane
Phone: (573) 751-4055

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded 315P00000X

Profile Details

NPI number 1194933499
LBN Legal business name State Of Missouri
DBA Doing business as South County Habilitation Center
Authorized official Boeckmann, Molly Jane
Entity Organization
Organization subpart 1 Yes
Enumeration date May 18th, 2007
Last updated Aug 26th, 2020 - about 4 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 1194933499 NPPES
Missouri MEDICAID 051780104

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