SOUTHEAST MISSOURI BEHAVIORAL HEALTH NPI 1609194448

NPI Information

NPI: 1609194448
Provider Name: SOUTHEAST MISSOURI BEHAVIORAL HEALTH

Former Legal Business Name: SOUTHEAST MISSOURI COMMUNITY TREATMENT CENTER

Classification: Clinic/Center - 261QR0405X
Entity Type: Organization

Specialization: Rehabilitation, Substance Use Disorder

Address:
216 PIEDMONT AVE STE 304
PIEDMONT, MO
ZIP 63957
Phone: (573) 223-2734
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SOUTHEAST MISSOURI BEHAVIORAL HEALTH is a rehabilitation and substance use disorder clinic center in Piedmont, MO. SOUTHEAST MISSOURI BEHAVIORAL HEALTH NPI is 1609194448. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Southeast Missouri Community Treatment Center.

The provider's business location address is:

216 PIEDMONT AVE STE 304
PIEDMONT, MO
ZIP 63957-017
Phone: (573) 223-2734
Fax: (573) 223-2764

The provider's authorized official is Barron E Pratte .
The authorized official title is President Ceo and has the following contact phone number (573) 431-0554.

The enumeration date for this NPI number is 5/4/2010 and was last updated on 5/4/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QR0405X	Clinic/Center	Rehabilitation, Substance Use Disorder			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	ADA-SDA4209122	OTHER	MISSOURI	PR PLUS CONTRACT PROVIDER WITH DMH

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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