| Southwest Mo Psychiatric Rehabilitation Center | |
|
1301 Industrial Pkwy E El Dorado Springs MO 64744-6263 | |
| (417) 876-1002 | |
| (417) 876-1004 |
| Full Name | Southwest Mo Psychiatric Rehabilitation Center |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 1301 Industrial Pkwy E, El Dorado Springs, Missouri |
| Authorized Official Name and Position | Molly Jane Boeckmann (DIRECTOR OF ADMINISTRATIVE SERVICES) |
| Authorized Official Contact | 5737514055 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southwest Mo Psychiatric Rehabilitation Center 1706 E Elm St Jefferson City MO 65101-4130 Ph: (573) 751-3398 | Southwest Mo Psychiatric Rehabilitation Center 1301 Industrial Pkwy E El Dorado Springs MO 64744-6263 Ph: (417) 876-1002 |
| NPI Number | 1396798237 |
|---|---|
| Provider Enumeration Date | 05/19/2006 |
| Last Update Date | 08/26/2020 |
| Certification Date | 08/26/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396798237 | NPI | - | NPPES |
| 501499909 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |