# SOUTH CENTRAL MISSOURI COMMUNITY HEALTH CENTER

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Your Community Health Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255867479
- **Authorized official:** KELLY MILLER (CEO)
- **Authorized official phone:** (573) 426-6712

## Contact information

- **Practice address:** 200 N MAIN ST, SUITE 51G, ROLLA, MO 65401-3061
- **Practice address phone:** (573) 426-6712
- **Practice address fax:** (573) 426-6735
- **Mailing address:** 200 N MAIN ST, SUITE 51G, ROLLA, MO 65401-3061
- **Mailing address phone:** (573) 426-6712
- **Mailing address fax:** (573) 426-6735

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/09/2017
- **Last updated:** 05/09/2017