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ST. LOUIS DEVELOPMENTAL DISABILITIES TREATMENT CENTER ISL
NPI 1942442702
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Saint Louis, MO

Active since March 25, 2009
11 BRADY CIR, SAINT LOUIS, MO 63114(314) 877-1624(314) 877-5666 Get Directions Write a Review

NPPES record last updated: August 28, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 28, 2020, Aug 26, 2019 (2 updates tracked since 2019).

About St. Louis Developmental Disabilities Treatment Center Isl NPPES

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

ST. LOUIS DEVELOPMENTAL DISABILITIES TREATMENT CENTER ISL (NPI 1942442702) is a healthcare organization registered as a community based residential treatment facility, intellectual and/or developmental disabilities in Saint Louis, Missouri and active in the NPI registry since March 2009. The organization lists Molly Jane Boeckmann, Director Of Administrative Services, as its authorized official.

NPPES Registry Identity

NPI1942442702
Entity TypeOrganization
Primary Taxonomy320900000X
Legal Business NameSTATE OF MISSOURI
Location Address11 BRADY CIRSaint Louis, MO 63114-1110
Mailing Address1706 E Elm StJefferson City, MO 65101-4130 · (573) 751-3398 · Fax (573) 526-4560
Phone(314) 877-1624
Fax(314) 877-5666
Organization SubpartYes
Authorized OfficialMolly Jane BoeckmannDirector Of Administrative Services · (573) 751-4055
Enumeration DateMarch 25, 2009
Last NPPES UpdateAugust 28, 20202 updates tracked since enumeration
NPPES CertifiedAugust 28, 2020
✔ NPI 1942442702 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCommunity Based Residential Treatment Facility, Intellectual and/or Developmental DisabilitiesResidential Treatment Facilities
Taxonomy Code320900000X
Definition
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities.
11 BRADY CIR, Saint Louis, MO 63114
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Other Names 1

Doing Business AsSt. Louis Developmental Disabilities Treatment Center Isl

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
Intermediate Care Facility, Intellectual Disabilities
11 BRADY CIR
OVERLAND, MO 63114
St. Louis County (314) 428-8470
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

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 1942442702. It was assigned to this organization in the NPPES registry on March 25, 2009. The provider is doing business as St. Louis Developmental Disabilities Treatment Center Isl.

Where is State Of Missouri located?

State Of Missouri is located at 11 Brady Cir, Saint Louis, MO 63114. The listed phone number is (314) 877-1624.

What is State Of Missouri's specialty?

The primary specialty registered for this NPI is Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities with taxonomy code 320900000X.

When was this NPI record last updated?

The NPPES record for State Of Missouri was last updated on August 28, 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.