Organization
NORTHEAST MISSOURI HEALTH COUNCIL, INC.
Active
Other names
Northeast Missouri Behavioral Health
Organization subpart
No
Provider details
NPI number
Authorized official
MARILYN GREEN (EXECUTIVE ASSISTANT)
(660) 627-5757
Entity
Organization
Contact information
Practice address
159 E COMMERCIAL ST, KAHOKA, MO 63445-1701
(660) 627-3621
(660) 627-5798
Mailing address
1416 CROWN DR, KIRKSVILLE, MO 63501-2548
(660) 627-5757
(660) 627-6285
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
2010017942
MO
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1104147552
—
MO
Enumeration date
05/10/2010
Last updated
06/17/2011
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