Organization
EAST CENTRAL MISSOURI BEHAVIORAL HEALTH SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEANANN EARLY (DIRECTOR OF COMPLIANCE)
(573) 582-1234
Entity
Organization
Contact information
Practice address
1225 AGUILAR DR., MONTGOMERY CITY, MO 63361
(573) 582-1234
(573) 582-1212
Mailing address
340 KELLEY PKWY, MEXICO, MO 65265-3811
(573) 581-1196
(573) 581-1981
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500100410
—
MO
Enumeration date
04/27/2020
Last updated
12/12/2024
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