# SOUTHEAST HEALTH CENTER OF STODDARD COUNTY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** SOUTHEAST HEALTH CENTER OF STODDARD COUNTY, LLC
- **Other names:** SoutheastHEALTH Children's Clinic of Dexter
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1710047618
- **Legal business name:** SOUTHEAST HEALTH CENTER OF STODDARD COUNTY, LLC
- **Authorized official:** PAULA E HARRIS (VICE PRESIDENT REGIONAL OPERATIONS)
- **Authorized official phone:** (573) 778-0020

## Contact information

- **Practice address:** 1300 N ONE MILE RD, SUITE 2, DEXTER, MO 63841-1042
- **Practice address phone:** (573) 624-7662
- **Mailing address:** PO BOX 368, DEXTER, MO 63841-0368
- **Mailing address phone:** (573) 624-3165
- **Mailing address fax:** (573) 624-3157

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR1300X | Rural Health Clinic/Center | — | MO | Yes |

## Other

- **Enumeration date:** 12/11/2006
- **Last updated:** 10/18/2013