NPI:
1831417682
Provider Name:
SOUTHEAST MISSOURI BEHAVIORAL HEALTH
Former Legal Business Name: SOUTHEAST MISSOURI COMMUNITY TREATMENT CENTER
Classification:
Clinic/Center - 261QR0405X
Entity Type:
Organization
Specialization: Rehabilitation, Substance Use Disorder
Address:
143 S MAIN ST
IRONTON, MO
ZIP 63650
Phone:
(573) 546-4005
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SOUTHEAST MISSOURI BEHAVIORAL HEALTH is a rehabilitation and substance use disorder clinic center in Ironton, MO. SOUTHEAST MISSOURI BEHAVIORAL HEALTH NPI is 1831417682. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Southeast Missouri Community Treatment Center.
The provider's business location address is:
143 S MAIN ST
IRONTON, MO
ZIP 63650-305
Phone: (573) 546-4005
Fax: (573) 546-4014
The provider's authorized official is Barron E Pratte .
The authorized official title is President Ceo and has the following contact phone number (573) 431-0554.
The enumeration date for this NPI number is 5/4/2010 and was last updated on 5/4/2010.