| Organization Name: | STATE OF MISSOURI |
| NPI Number: | 1427002013 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | BRENT MCGINTY (DMH DIRECTOR OF ADMINISTRATION) |
| Mailing Address: | 5300 Arsenal St Saint Louis |
| State: | MO US |
| Postal Code: | 631391463 |
| Phone Number: | 3146448000 |
| Fax Number: | |
| NPI Enumeration Date: | 05/19/2006 |
| NPI Last Update Date: | 12/15/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |