Organization
SOUTHEAST INC
Active
Parent organization
SOUTHEAST INC
Other names
SOUTHEAST HEALTHCARE
Organization subpart
Yes
Provider details
NPI number
Legal business name
SOUTHEAST INC
Authorized official
CHARLES TONG (CFO)
(614) 813-0177
Entity
Organization
Contact information
Practice address
611 HIGH ST NW, CARROLLTON, OH 44615-1117
(330) 627-3954
(330) 627-3984
Mailing address
16 W LONG ST, COLUMBUS, OH 43215-2815
(614) 225-0980
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0011867
—
OH
Enumeration date
08/29/2022
Last updated
01/16/2026
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