SOUTHEAST MISSOURI BEHAVIORAL HEALTH (NPI# 1609194448) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609194448 |
| Entity Type | Organization |
| Organization Name | SOUTHEAST MISSOURI BEHAVIORAL HEALTH |
| Other Organization Name | SOUTHEAST MISSOURI COMMUNITY TREATMENT CENTER |
| Practice Address |
216 Piedmont Ave Ste 304 Piedmont MO 63957-1017 |
| Mailing Address |
512 E Main St Po Box 506 Park Hills MO 63601-2624 |
| Practice Telephone | 5732232734 |
| Practice Fax Number | 5732232764 |
| Mailing Telephone | 5734310554 |
| Mailing Fax Number | 5734315205 |
| Enumeration Date | 2010-05-04 |
| Last Update Date | 2010-05-04 |
| Authorized Official Name | DR. BARRON E PRATTE (PRESIDENT CEO) |
| Authorized Official Telephone | 5734310554 |
| Authorized Official Credential | PH.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | PR PLUS CONTRACT PROVIDER WITH DMH | ADA-SDA4209122 | 01 |
| Other Name | Type Code |
|---|---|
| Southeast Missouri Community Treatment Center | Former Legal Business Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184949372 | Southeast Missouri Behavioral Health | Clinic/Center | 1014 W Highway 28 Ste E, Owensville, MO 65066-1679 | 2010-03-31 |
| 1023176054 | Southeast Missouri Behavioral Health | Clinic/Center | 5536 State Highway 32, Po Drawer 459, Farmington, MO 63640-7357 | 2006-12-04 |
| 1841645801 | Southeast Missouri Behavioral Health | Clinic/Center | 5536 Hwy 32, Farmington, MO 63640-7357 | 2016-04-27 |
| 1013362078 | Southeast Missouri Behavioral Health | Clinic/Center | 5536 Hwy 32, Farmington, MO 63640-7357 | 2016-04-27 |
| 1053795005 | Southeast Missouri Behavioral Health | Community/Behavioral Health | 512 E Main St, Park Hills, MO 63601-2624 | 2015-07-18 |
| 1134492390 | Southeast Missouri Behavioral Health | Substance Abuse Rehabilitation Facility | 101 S Main St, Poplar Bluff, MO 63901-5843 | 2012-02-20 |
| 1831417682 | Southeast Missouri Behavioral Health | Clinic/Center | 143 S Main St, Ironton, MO 63650-1305 | 2010-05-04 |
| 1144372517 | Southeast Missouri Behavioral Health | Clinic/Center | 5536 State Highway 32, Po Drawer 459, Farmington, MO 63640-7357 | 2007-01-17 |
| Street Address |
216 PIEDMONT AVE STE 304 |
| City | PIEDMONT |
| State | MO |
| Zip Code | 63957-1017 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720624323 | Toney Drug & Wellness, LLC | Pharmacy | #1 Hals Plaza Dr, Piedmont, MO 63957 | 2019-11-19 |
| 1700432838 | April Dawn Gibson | Behavior Technician | 306 North 2nd Street, Piedmont, MO 63957 | 2019-08-14 |
| 1457844748 | Town and Country Super Market Inc | Pharmacy | #7 Hal's Plaza, Piedmont, MO 63957 | 2018-06-11 |
| 1528588522 | Ashley Dawn Janecek | Case Manager/Care Coordinator | 306 N Second St, Piedmont, MO 63957 | 2017-06-21 |
| 1649587031 | Joseph Michael Toney | Family Medicine | #1 Hals Plaza Drive, Piedmont, MO 63957 | 2010-09-07 |
| 1184825770 | Clearwater Ambulance District | Ambulance | 117 B, Piedmont, MO 63957 | 2007-05-30 |
| 1629129457 | Roy Eugene Winters | Pharmacist | #1hals Plaza, Piedmont, MO 63957 | 2007-01-16 |
| 1386655322 | Toneys Drug & Wellness, LLC | Pharmacy | 1 Hal's Plaza Drive, Piedmont, MO 63957 | 2006-08-11 |
| 1407880099 | Michael P Toney | Family Medicine | #1 Hal's Plaza Drive, Piedmont, MO 63957 | 2006-07-10 |
| 1972549053 | Poplar Bluff Regional Medical Center LLC | Clinic/Center | #1 Hal's Plaza, Piedmont, MO 63957 | 2006-06-20 |
| Find all providers in zip 63957 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427269588 | Capitol Business Development Inc | Clinic/Center | 6300 Moraga Ave, Piedmont, CA 94611-2256 | 2007-05-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487179057 | Gateway Foundation, Inc. | Clinic/Center | 1430 Olive St Ste 300, Saint Louis, MO 63103-2303 | 2017-08-04 |
| 1700233145 | New Beginnings C-star | Clinic/Center | 1408 N Kingshighway Blvd Ste 4, Saint Louis, MO 63113-1426 | 2016-05-16 |
| 1629432182 | Clark Community Mental Health Center | Clinic/Center | 1701 N Central Ave, Monett, MO 65708 | 2016-04-11 |
| 1083024061 | Avertest, LLC | Clinic/Center | 4709 Laguardia Dr, Suite 100, Saint Louis, MO 63134 | 2014-04-30 |
| 1659718609 | Hannibal Council On Alcohol & Drug Abuse | Clinic/Center | 146 Communication Dr, Hannibal, MO 63401-3672 | 2013-05-31 |
| 1194026765 | Family Counseling Center, Inc. | Clinic/Center | 500 Us Hwy 61 North, Hayti, MO 63851 | 2010-11-12 |
| 1942501143 | Swope Health Services | Clinic/Center | 3950 E 51st St, Kansas City, MO 64130-3081 | 2010-11-04 |
| 1750682043 | Black Alcohol/drug Service Information Center | Clinic/Center | 3026 Locust St, Saint Louis, MO 63103-1329 | 2010-11-03 |
| 1932412186 | Comprehensive Mental Health Services, Inc/renaisance West | Clinic/Center | 5840 Swope Pkwy, Kansas City, MO 64130-4262 | 2010-07-16 |
| 1043536626 | Kansas City Community Center | Clinic/Center | 622 Benton Blvd, Kansas City, MO 64124-2559 | 2010-04-08 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on SOUTHEAST MISSOURI BEHAVIORAL HEALTH.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.