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State of Missouri

Intellectual Disabilities Intermediate Care Facility in Nevada, MO · enumerated 2006 · authorized official Molly Boeckmann, Director of Administrative Services.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1376614701

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Registry record

Entity type Organization (Type 2)
Legal business name State of Missouri
Other name <Unavail>
Parent organization State of Missouri
Practice address 2323 N Ash St, Nevada, MO, 64772
Phone (417) 667-7833
Fax (417) 448-1138
Enumeration date Nov 9, 2006
Last updated in NPPES Sep 3, 2020

Taxonomy & classification

315P00000X Intellectual Disabilities Intermediate Care Facility Nursing & Custodial Care Facilities · License EXEMPT (MO) Primary

Authorized official

Name Molly Boeckmann
Title Director of Administrative Services
Phone (573) 751-4055

Other identifiers

Identifier Type State Issuer
051499903 Medicaid MO -

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

How current is this record?
Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2020-09-03. Verify at npiregistry.cms.hhs.gov.
Where is State of Missouri located?
The practice location on file with NPPES is in Nevada, MO.

Providers at this address

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2020-09-03.