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NPI 1447375084 · Mental Illness Intermediate Care Facility · Urbana, MO
Provider details
- NPI number
- 1447375084
- Entity type
- Organization
- Primary specialty
- Mental Illness Intermediate Care FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Gary Boggs, President(417) 722-4416
Specialties & taxonomies
Nursing & Custodial Care Facilities
Practice location
27 Hopper Trl
Urbana, MO 65767-9234
Phone: (417) 833-9366
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.