| Organization Name: | EAST CENTRAL MISSOURI BEHAVIORAL HEALTH SERVICES, INC |
| NPI Number: | 1104980267 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | TERRY MACKEY (PRESIDENT) |
| Mailing Address: | 321 W Promenade St Mexico |
| State: | MO US |
| Postal Code: | 652652719 |
| Phone Number: | 5735821234 |
| Fax Number: | 5735821212 |
| NPI Enumeration Date: | 12/21/2006 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TR0400X |
| License Number: | 5726-7685 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Rehabilitation |
| Taxonomy Definition: | |