Organization
SOUTHEAST MISSOURI BEHAVIORAL HEALTH
Active
Other names
Southeast Missouri Community Treatment Center
Organization subpart
No
Provider details
NPI number
Authorized official
BARRON E PRATTE PH.D. (PRESIDENT)
(573) 756-5749
Entity
Organization
Contact information
Practice address
5536 HWY 32, FARMINGTON, MO 63640-7357
(573) 756-5749
(573) 431-5205
Mailing address
5536 HWY 32, FARMINGTON, MO 63640-7357
(573) 756-5749
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
1465
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
876173303
—
MO
Enumeration date
04/27/2016
Last updated
04/27/2016
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