| Southeast, Inc. | |
|
16 W Long St Columbus OH 43215-2815 | |
| (614) 225-0980 | |
| (614) 225-0986 |
| Full Name | Southeast, Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 16 W Long St, Columbus, Ohio |
| Authorized Official Name and Position | John Bell (CFO) |
| Authorized Official Contact | 6142250980 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southeast, Inc. 16 W Long St Columbus OH 43215-2815 Ph: (614) 225-0980 | Southeast, Inc. 16 W Long St Columbus OH 43215-2815 Ph: (614) 225-0980 |
| NPI Number | 1366703084 |
|---|---|
| Provider Enumeration Date | 05/30/2012 |
| Last Update Date | 12/27/2019 |
| Certification Date | 12/27/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366703084 | NPI | - | NPPES |
| 2373177 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 0600 (Ohio) | Primary |
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