| Southeast Missouri Community Treatment Center, Inc. | |
|
202 W 3rd St Apt A Washington MO 63090-2320 | |
| (573) 760-3874 | |
| (573) 431-5205 |
| Full Name | Southeast Missouri Community Treatment Center, Inc. |
|---|---|
| Speciality | Counselor - Professional |
| Location | 202 W 3rd St Apt A, Washington, Missouri |
| Authorized Official Name and Position | Barron Pratte (CEO/PRESIDENT) |
| Authorized Official Contact | 5734310554 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southeast Missouri Community Treatment Center, Inc. Po Box 506 512 E. Main St. Park Hills MO 63601-0506 Ph: (573) 431-0554 | Southeast Missouri Community Treatment Center, Inc. 202 W 3rd St Apt A Washington MO 63090-2320 Ph: (573) 760-3874 |
| NPI Number | 1992988992 |
|---|---|
| Provider Enumeration Date | 12/12/2007 |
| Last Update Date | 12/12/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992988992 | NPI | - | NPPES |
| 001751 | Other | MO | LPC LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 001751 (Missouri) | Primary |
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