Organization
SOUTHEAST HEALTH CENTER OF STODDARD COUNTY, LLC
Active
Parent organization
SOUTHEAST HEALTH CENTER OF STODDARD COUNTY, LLC
Other names
Southeast Home Health of Dexter
Organization subpart
Yes
Provider details
NPI number
Legal business name
SOUTHEAST HEALTH CENTER OF STODDARD COUNTY, LLC
Authorized official
MRS. PAULA HARRIS (VP REGIONAL OPERATIONS)
(573) 778-0020
Entity
Organization
Contact information
Practice address
1300 N ONE MILE RD, SUITE 7, DEXTER, MO 63841-1042
(573) 624-3511
(573) 624-5839
Mailing address
1300 N ONE MILE RD, SUITE 7, DEXTER, MO 63841-1042
(573) 624-3511
(573) 624-5839
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
760
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
54
BLUECROSS/BLUESHIELD
MO
05
—
580722601
—
MO
Enumeration date
06/15/2005
Last updated
10/31/2013
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