| Organization Name: | SSM REGIONAL HEALTH SERVICES |
| NPI Number: | 1053368159 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ROBERT B VAN CONIA (PRESIDENT) |
| Mailing Address: | 2701 West Edgewood Suite 101 Jefferson City |
| State: | MO US |
| Postal Code: | 65109 |
| Phone Number: | 5736345303 |
| Fax Number: | 5737616888 |
| NPI Enumeration Date: | 05/27/2006 |
| NPI Last Update Date: | 05/21/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QM0801X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Mental Health (Including Community Mental Health Center) |
| Taxonomy Definition: | |