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100 Saint Marys Plz Jefferson City MO 65101-1602 | |
| (573) 761-7000 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 100 Saint Marys Plz, Jefferson City, Missouri |
| Authorized Official Name and Position | Brent Vanconia (PRESIDENT) |
| Authorized Official Contact | 5737617153 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
100 St. Marys Medical Plaza Jefferson City MO 65101 Ph: (573) 761-7000 | 100 Saint Marys Plz Jefferson City MO 65101-1602 Ph: (573) 761-7000 |
| NPI Number | 1386786119 |
|---|---|
| Provider Enumeration Date | 02/12/2007 |
| Last Update Date | 11/27/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386786119 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | (* (Not Available)) | Primary |
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