MEDICARE: SKILLS DEVELOPMENT, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251C00000X	Developmentally Disabled Services Day Training Agency

General Provider Information

NPI Number	:	1922126978
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SKILLS DEVELOPMENT, INC.

Provider Business Mailing Address
First Line	:	2923 SAINT MARYS AVE
Second Line	:
City	:	HANNIBAL
State	:	MO
Zip	:	63401-3714
Country	:	US
Telephone Number	:	573-221-3282
Fax Number	:

Provider Business Practice Location Address
First Line	:	2923 SAINT MARYS AVE
Second Line	:
City	:	HANNIBAL
State	:	MO
Zip	:	63401-3714
Country	:	US
Telephone Number	:	573-221-3282
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MRS. JANE N. HICKMAN
Credential	:
Telephone Number	:	573-221-1705

Provider Enumeration Date	:	03/27/2007
Last Update Date	:	08/22/2020

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