| Southeast Missouri Behavioral Health | |
|
5536 Hwy 32 Farmington MO 63640-7357 | |
| (573) 756-5749 | |
| (573) 431-5205 |
| Full Name | Southeast Missouri Behavioral Health |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 5536 Hwy 32, Farmington, Missouri |
| Authorized Official Name and Position | Barron E Pratte (PRESIDENT) |
| Authorized Official Contact | 5737565749 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southeast Missouri Behavioral Health 5536 Hwy 32 Farmington MO 63640-7357 Ph: (573) 756-5749 | Southeast Missouri Behavioral Health 5536 Hwy 32 Farmington MO 63640-7357 Ph: (573) 756-5749 |
| NPI Number | 1013362078 |
|---|---|
| Provider Enumeration Date | 04/27/2016 |
| Last Update Date | 04/27/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013362078 | NPI | - | NPPES |
| 876173303 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | 1465 (Missouri) | Primary |
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