SOUTHEAST MISSOURI BEHAVIORAL HEALTH (NPI# 1841645801) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841645801 |
| Entity Type | Organization |
| Organization Name | SOUTHEAST MISSOURI BEHAVIORAL HEALTH |
| Other Organization Name | SOUTHEAST MISSOURI COMMUNITY TREATMENT CENTER |
| Practice Address |
5536 Hwy 32 Farmington MO 63640-7357 |
| Practice Telephone | 5737565749 |
| Practice Fax Number | 5734315205 |
| Mailing Telephone | 5737565749 |
| Mailing Fax Number | 5734315205 |
| Enumeration Date | 2016-04-27 |
| Last Update Date | 2016-04-27 |
| Authorized Official Name | DR. BARRON E PRATTE (PRESIDENT) |
| Authorized Official Telephone | 5737565749 |
| 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 |
1465 | MO | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Southeast Missouri Community Treatment Center | Former Legal Business Name - Organization |
| 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 |
| 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 |
5536 HWY 32 |
| City | FARMINGTON |
| State | MO |
| Zip Code | 63640-7357 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982875407 | Southeast Missouri Behavioral Health Inc | Community/Behavioral Health | 5536 Hwy 32, Farmington, MO 63640-7357 | 2008-03-13 |
| 1013362078 | Southeast Missouri Behavioral Health | Clinic/Center | 5536 Hwy 32, Farmington, MO 63640-7357 | 2016-04-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316545254 | Brenda S Halton | Nurse Practitioner | 1010 West Columbia Street, Farmington, MO 63640 | 2020-10-13 |
| 1619519089 | Stacey Nicole Gillette | Counselor | 17885 Hart Pinkston Rd, Farmington, MO 63640 | 2019-10-17 |
| 1346890696 | Christopher Ryan Massey | Social Worker | 607 Pine St., Farmington, MO 63640 | 2019-09-18 |
| 1457909376 | Clarice Ogden | Social Worker | 203 South Washington Street, Farmington, MO 63640 | 2019-09-04 |
| 1861979718 | Clint Thebeau | In Home Supportive Care | 1276 W Liberty St, Farmington, MO 63640 | 2018-07-24 |
| 1023500600 | Lynn Machelle Knox | Counselor | 219 W Columbia St, Farmington, MO 63640 | 2018-05-31 |
| 1235620576 | Kim Bazzell | Registered Nurse | 1565 Ste. Genevieve Ave., Farmington, MO 63640 | 2018-05-22 |
| 1164919742 | Lincare Inc. | Durable Medical Equipment & Medical Supplies | 774 Market St, Farmington, MO 63640 | 2018-04-18 |
| 1184127813 | Michelle Lynette Corvallis | Chiropractor | 17 South Franklin St., Farmington, MO 63640 | 2018-03-08 |
| 1992206213 | Farmington Vision Care LLC | Optometrist | 110 E Harrison St, Farmington, MO 63640 | 2018-02-22 |
| Find all providers in zip 63640 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144788514 | Lifechoices LLC | Clinic/Center | 417 E Main St Ste A, Farmington, NM 87401-2752 | 2019-03-05 |
| 1023176054 | Southeast Missouri Behavioral Health | Clinic/Center | 5536 State Highway 32, Po Drawer 459, Farmington, MO 63640-7357 | 2006-12-04 |
| 1124101464 | Evergreen Behavioral Services | Clinic/Center | 131 Franklin Health Commons, Suite A Mt Blue Health Center, Farmington, ME 04938 | 2006-10-23 |
| 1780129924 | Renaissance Ranch Outpatient Farmington | Clinic/Center | 1466 N Highway 89, Suite 230, Farmington, UT 84025-2738 | 2016-12-26 |
| 1902251507 | Mineral Area Community Psychiatric Rehabilitation Center, Inc. | Clinic/Center | 560 W Pine St, Farmington, MO 63640-1426 | 2016-05-02 |
| 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 |
| 1609194448 | Southeast Missouri Behavioral Health | Clinic/Center | 216 Piedmont Ave Ste 304, Piedmont, MO 63957-1017 | 2010-05-04 |
| Find all providers with the same taxonomy | ||||
| City | FARMINGTON |
| Zip Code | 63640 |
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.