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NPI 1033234919 · Mental Illness Intermediate Care Facility · Urbana, MO
Provider details
- NPI number
- 1033234919
- Entity type
- Organization
- Primary specialty
- Mental Illness Intermediate Care FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Gary Boggs, President(417) 722-4417
Specialties & taxonomies
Nursing & Custodial Care Facilities
Profile Score
Detailed profile(89/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
399 State Road Bb
Urbana, MO 65767-9253
Phone: (417) 993-5128
Fax: (417) 722-4417
Approximate (ZIP-level) locationGet directions
Mailing address
27 Hopper Trl
Urbana, MO 65767-9234
Registry dates
- Enumerated
- 2007-03-20
- Last updated
- 2020-08-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.