Organization
SOUTHEAST MISSOURI HEALTH NETWORK
Active
Other names
Sikeston Alternative Education Center Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
SARA DEANE CFO (CHIEF FINANCIAL OFFICER)
(573) 313-2500
Entity
Organization
Contact information
Practice address
835 W MURRAY LN, SIKESTON, MO 63801-4056
(573) 472-8808
Mailing address
6738 STATE HIGHWAY 77, BENTON, MO 63736-8238
(573) 313-2500
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500077951
—
MO
Enumeration date
11/19/2019
Last updated
04/14/2020
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