Organization
SOUTHEAST MISSOURI COMMUNITY TREATMENT CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BARRON E PRATTE PH.D. (PRESIDENT CEO)
(573) 431-0554
Entity
Organization
Contact information
Practice address
101 S MAIN ST, POPLAR BLUFF, MO 63901-5843
(573) 686-5090
(573) 785-4104
Mailing address
512 E MAIN ST, PO BOX 506, PARK HILLS, MO 63601-2624
(573) 431-0554
(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
—
866204605
—
MO
Enumeration date
12/13/2006
Last updated
05/06/2008
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