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NORTH WEST HABILITATION CENTER
NPI 1164630463
Intermediate Care Facility, Intellectual Disabilities in Overland, MO

Active since May 18, 2007
11 BRADY CIR, OVERLAND, MO 63114(314) 428-8470 Get Directions Write a Review

NPPES record last updated: October 27, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Oct 27, 2020, Aug 28, 2019 (2 updates tracked since 2019).

About North West Habilitation Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NORTH WEST HABILITATION CENTER (NPI 1164630463) is a healthcare organization registered as an intermediate care facility, intellectual disabilities in Overland, Missouri and active in the NPI registry since May 2007. The organization lists Molly Jane Boeckmann, Director Of Administrative Services, as its authorized official.

NPPES Registry Identity

NPI1164630463
Entity TypeOrganization
Primary Taxonomy315P00000X
Legal Business NameSTATE OF MISSOURI
Location Address11 BRADY CIROverland, MO 63114-1110
Mailing Address1706 E Elm StJefferson City, MO 65101-4130 · (573) 751-3398 · Fax (573) 526-4560
Phone(314) 428-8470
Organization SubpartYes
Authorized OfficialMolly Jane BoeckmannDirector Of Administrative Services · (573) 751-4055
Enumeration DateMay 18, 2007
Last NPPES UpdateOctober 27, 20202 updates tracked since enumeration
NPPES CertifiedOctober 27, 2020
✔ NPI 1164630463 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyIntermediate Care Facility, Intellectual DisabilitiesNursing & Custodial Care Facilities
Taxonomy Code315P00000X
Definition
An intermediate care facility providing services for individuals with intellectual disabilities.
11 BRADY CIR, Overland, MO 63114
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Other Names 1

Doing Business AsNorth West Habilitation Center

Other Identifiers 1

Medicaid052361904MO

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

STATE OF MISSOURI
Residential Treatment Facility, Intellectual and/or Developmental Disabilities
11 BRADY CIR, 2
SAINT LOUIS, MO 63114
St. Louis County (314) 340-6701
STATE OF MISSOURI
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
11 BRADY CIR
SAINT LOUIS, MO 63114
St. Louis County (314) 877-1624

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is State Of Missouri's NPI number?

The NPI number for State Of Missouri is 1164630463. It was assigned to this organization in the NPPES registry on May 18, 2007. The provider is doing business as North West Habilitation Center.

Where is State Of Missouri located?

State Of Missouri is located at 11 Brady Cir, Overland, MO 63114. The listed phone number is (314) 428-8470.

What is State Of Missouri's specialty?

The primary specialty registered for this NPI is Intermediate Care Facility, Intellectual Disabilities with taxonomy code 315P00000X.

When was this NPI record last updated?

The NPPES record for State Of Missouri was last updated on October 27, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.