Southeast Missouri Behavioral Health
Organization Active NPI Substance Abuse Rehabilitation Facility · Poplar Bluff, MO
NPI 1134492390 · NPPES record last updated Feb 20, 2012
Key facts
- NPI
- 1134492390
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Substance Abuse Rehabilitation Facility 324500000X
- Legal business name
- SOUTHEAST MISSOURI BEHAVIORAL HEALTH
- Practice address
- 101 S Main St
Poplar Bluff, MO 63901-5843 - Phone
- (573) 686-5090
- NPI assigned
- Feb 20, 2012
- Organization subpart
- No
Authorized official
- Name
- Dr. Barron E Pratte, PH.D.
- Title
- President/Ceo
- Phone
- (573) 431-0554
Corporate family (same tax ID) 14
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 26D2337477 | Southeast Missouri Behavioral Health - | Certificate of waiver | Jan 22, 2028 |
National Provider Directory
- Tax ID family
- Southeast Missouri Behavioral Health
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Substance Abuse Rehabilitation Facility | 324500000X | Yes |
Addresses
Primary practice location
101 S Main St
Poplar Bluff, MO 63901-5843
Mailing address
101 S Main St
Poplar Bluff, MO 63901-5843
Phone (573) 686-5090
Other providers in Poplar Bluff, MO
- Pamella Joanne Soto
- Sound Imaging Inc LLC
- Southeast Health Center of Stoddard County, LLC
- Southeast Health Pharmacy LLC
- Southeast Missouri Anesthesia Partners LLC
- Southeast Missouri Community Treatment Center Inc
- Southeast Missouri Community Treatment Center, Inc.
- Southeast Missouri Residential Services
- Southeast Rehabilitation, LLC
- Southeasthealth Hospital Holdings, LLC
All providers in Poplar Bluff, MO · Substance Abuse Rehabilitation Facility in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 20, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.