St. Louis Developmental Disabilities Treatment Center
LBN: State Of Missouri
St. Louis Developmental Disabilities Treatment Center is an health care organization with primary practice located at 22 Marr Ln , Saint Charles MO 63303-9000. The organization recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Urology, Allopathic & Osteopathic Physicians / General Practice. Allopathic & Osteopathic Physicians / General Practice is the primary health care specialty.
State Of Missouri can be contacted via phone (314) 340-6702, or through Boeckmann, Molly Jane via phone (573) 751-4055.
Contact Information
Primary practice address
22 Marr Ln
Saint Charles MO 63303-9000
Phone: (314) 340-6702
Fax: (314) 340-6724
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | ||
| Allopathic & Osteopathic Physicians / Urology | 208800000X | ||
| Allopathic & Osteopathic Physicians / General Practice | 208D00000X |
Profile Details
| NPI number | 1316991896 |
|---|---|
| LBN Legal business name | State Of Missouri |
| DBA Doing business as | St. Louis Developmental Disabilities Treatment Center |
| Authorized official | Boeckmann, Molly Jane |
| Entity | Organization |
| Organization subpart 1 | Yes |
| Enumeration date | May 20th, 2006 |
| Last updated | Oct 20th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1316991896 | NPPES |
| Missouri | MEDICAID | 501500011 |
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