SOUTHEAST MISSOURI BEHAVIORAL HEALTH (NPI# 1134492390) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134492390 |
| Entity Type | Organization |
| Organization Name | SOUTHEAST MISSOURI BEHAVIORAL HEALTH |
| Practice Address |
101 S Main St Poplar Bluff MO 63901-5843 |
| Practice Telephone | 5736865090 |
| Mailing Telephone | 5736865090 |
| Enumeration Date | 2012-02-20 |
| Last Update Date | 2012-02-20 |
| 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 | 324500000X | Substance Abuse Rehabilitation Facility | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609194448 | Southeast Missouri Behavioral Health | Clinic/Center | 216 Piedmont Ave Ste 304, Piedmont, MO 63957-1017 | 2010-05-04 |
| 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 |
| 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 |
101 S MAIN ST |
| City | POPLAR BLUFF |
| State | MO |
| Zip Code | 63901-5843 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043849672 | Connie Bowens | Licensed Practical Nurse | 101 S Main St, Poplar Bluff, MO 63901-5843 | 2020-04-06 |
| 1104489939 | Sharon Sanders | Registered Nurse | 101 S Main St, Poplar Bluff, MO 63901-5843 | 2019-04-17 |
| 1255898516 | Minette A Hafford | Licensed Practical Nurse | 101 S Main St, Poplar Bluff, MO 63901-5843 | 2019-02-22 |
| 1316448079 | Lula Harris | Registered Nurse | 101 S Main St, Poplar Bluff, MO 63901-5843 | 2018-02-27 |
| 1346790490 | Steven Stacy | Counselor | 101 S Main St, Poplar Bluff, MO 63901-5843 | 2016-10-12 |
| 1659821247 | Katherine Matthews | Licensed Practical Nurse | 101 S Main St, Poplar Bluff, MO 63901-5843 | 2016-10-07 |
| 1013367457 | Ashlie Patty | Licensed Practical Nurse | 101 S Main St, Poplar Bluff, MO 63901-5843 | 2016-06-16 |
| 1144677667 | Janice Nicholson | Registered Nurse | 101 S Main St, Poplar Bluff, MO 63901-5843 | 2016-05-16 |
| 1780051607 | Angela Bush | Registered Nurse | 101 S Main St, Poplar Bluff, MO 63901-5843 | 2015-08-26 |
| 1093101990 | Rebekah Hodgkiss | Registered Nurse | 101 S Main St, Poplar Bluff, MO 63901-5843 | 2015-04-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568076701 | Alternative Sleep Solution | Dentist | 2700 Kanell Blvd., Poplar Bluff, MO 63901 | 2020-09-04 |
| 1285271239 | Front Door Wellness LLC | Physical Therapist | Front Door Wellness LLC, 5835 Quail Meadows Drive, Poplar Bluff, MO 63901 | 2019-12-09 |
| 1104470368 | Andrew Akindutire | Dentist | 3101 Oak Groove Rd., Suite 6, Poplar Bluff, MO 63901 | 2019-07-26 |
| 1780195966 | Midwest Equipment Srv Systems LLC | Technician, Pathology | 2400 Lucy Lee Parkway, Suite C, Poplar Bluff, MO 63901 | 2017-10-16 |
| 1801259387 | Richard Justin Huber | Technician, Other | 3005 Warrior Ln, Poplar Bluff, MO 63901 | 2016-04-01 |
| 1699136275 | Donja Kirkland | Recreation Therapist | 1910a Greenwood Dr., Suite D, Poplar Bluff, MO 63901 | 2016-03-10 |
| 1760866867 | Bio-medical Applications of Missouri, Inc. | Clinic/Center | 3050 Tucker Road, Poplar Bluff, MO 63901 | 2015-07-17 |
| 1407246390 | Lisa Marie Payne | Physical Therapist | 4358c Highway Pp, Poplar Bluff, MO 63901 | 2015-01-29 |
| 1700202488 | Missouri Dental Professionals, Richard Straus, Dmd, PC | Dentist | 1602 W. Harper Street, Poplar Bluff, MO 63901 | 2014-03-05 |
| 1932521648 | Essential Family Healthcare, LLC | Clinic/Center | 1369 North Westwood Blvd., Poplar Bluff, MO 63901 | 2014-01-15 |
| Find all providers in zip 63901 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073112967 | Hurdler Outreach Services LLC | Substance Abuse Rehabilitation Facility | 6425 Evanston Ave, Raytown, MO 64133-4931 | 2020-10-21 |
| 1912529041 | Ip Reserve | Substance Abuse Rehabilitation Facility | 21708 Nickel Ave, Gallatin, MO 64640-6369 | 2020-05-12 |
| 1417577107 | Sana Lake Recovery Center, LLC | Substance Abuse Rehabilitation Facility | 150 Sana Lake Recovery Way, Dittmer, MO 63023 | 2020-04-22 |
| 1639723463 | Haven Recovery Homes | Substance Abuse Rehabilitation Facility | 3929 Michigan Ave, Saint Louis, MO 63118-4324 | 2019-07-30 |
| 1356875678 | Summit Bhc Saint Louis, LLC | Substance Abuse Rehabilitation Facility | 22933 Hwy 61, Eolia, MO 63344 | 2017-04-13 |
| 1821549122 | Preferred Family Healthcare, Inc | Substance Abuse Rehabilitation Facility | 2415 W Catalpa St, Springfield, MO 65807-1123 | 2016-10-21 |
| 1225496052 | Betty Lou Wallace Recovery LLC | Substance Abuse Rehabilitation Facility | 13350 Holmes Rd, Kansas City, MO 64145-1437 | 2016-02-08 |
| 1326414350 | Synergy Recovery Center | Substance Abuse Rehabilitation Facility | 3955 S Farm Road 223, Rogersville, MO 65742-8807 | 2015-08-13 |
| 1821406174 | Preferred Family Healthcare, Inc | Substance Abuse Rehabilitation Facility | 4066 Dunnica, Saint Louis, MO 63118 | 2014-07-31 |
| 1932517653 | Summit Bhc Lafayette LLC | Substance Abuse Rehabilitation Facility | 551 Warren Ave, Saint Louis, MO 63130-4155 | 2014-07-25 |
| Find all providers with the same taxonomy | ||||
| City | POPLAR BLUFF |
| Zip Code | 63901 |
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.