Southeast Missouri Community Treatment Center
Organization Active NPI Counselor · Park Hills, MO
NPI 1043409709 · NPPES record last updated Oct 18, 2007
Key facts
- NPI
- 1043409709
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Counselor 101Y00000X
- License
- 2002032333 (MO)
- Legal business name
- SOUTHEAST MISSOURI COMMUNITY TREATMENT CENTER
- Practice address
- 512 E Main St
Park Hills, MO 63601-2624 - Phone
- (573) 431-0554
- NPI assigned
- Oct 18, 2007
- Organization subpart
- No
Authorized official
- Name
- Victoria E Hammond, LPC
- Title
- Counselor
- Phone
- (573) 431-0554
Corporate family (same tax ID) 14
National Provider Directory
- Tax ID family
- Southeast Missouri Behavioral Health
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor |
101Y00000X | 2002032333 | MO | Yes |
Addresses
Primary practice location
512 E Main St
Park Hills, MO 63601-2624
Mailing address
PO Box 506
Park Hills, MO 63601-0506
Other providers in Park Hills, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 18, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.