Organization
SOUTHEAST MISSOURI BEHAVIORAL HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BARRON E PRATTE PH.D. (PRESIDENT)
(573) 756-5749
Entity
Organization
Contact information
Practice address
5536 STATE HIGHWAY 32, PO DRAWER 459, FARMINGTON, MO 63640-7357
(573) 756-5749
(573) 756-7451
Mailing address
5536 HWY 32, PO DRAWER 459, FARMINGTON, MO 63640-7357
(573) 756-5749
(573) 431-5205
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
866204803
—
MO
Enumeration date
12/04/2006
Last updated
03/31/2016
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