Organization Name: | SOUTHEAST MISSOURI BEHAVIORAL HEALTH |
NPI Number: | 1013362078 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | BARRON E PRATTE (PRESIDENT) |
Mailing Address: | 5536 Hwy 32 Farmington |
State: | MO US |
Postal Code: | 636407357 |
Phone Number: | 5737565749 |
Fax Number: | 5734315205 |
NPI Enumeration Date: | 04/27/2016 |
NPI Last Update Date: | 04/27/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QM0850X |
License Number: | 1465 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Adult Mental Health |
Taxonomy Definition: | An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |