NPIMap

Organization Active NPI

Southeast Missouri Behavioral Health

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Owensville, MO
National Provider Identifier
1184949372
Registry record updated May 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
SOUTHEAST MISSOURI BEHAVIORAL HEALTH
Practice address
1014 W Highway 28 Ste E
Owensville, MO 65066-1679
Phone
(573) 437-7347
NPI assigned
Mar 31, 2010
Last updated
May 4, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 4, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Barron E Pratte, PH.D.
Title
President Ceo
Phone
(573) 431-0554

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X NU Primary

Addresses

Primary practice location

1014 W Highway 28 Ste E
Owensville, MO 65066-1679

Mailing address

512 E Main St
PO Box 506
Park Hills, MO 63601-2624
Phone (573) 431-0554

Other identifiers 1

IdentifierTypeStateIssuer
ADA-SDA4200053OtherMOPR PLUS CONTRACT PROVIDER NUMBER WITH DMH

Other names 1

  • Southeast Missouri Community Treatment Center Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Southeast Missouri Behavioral Health15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

Locations

1014 W Highway 28
Ste E
Owensville, MO 65066
Phone (573) 437-7347

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1269993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1272931200000",
    "number": "1184949372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "512 E MAIN ST",
            "address_2": "PO BOX 506",
            "city": "PARK HILLS",
            "state": "MO",
            "postal_code": "636012624",
            "telephone_number": "573-431-0554",
            "fax_number": "573-431-5205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1014 W HIGHWAY 28 STE E",
            "city": "OWENSVILLE",
            "state": "MO",
            "postal_code": "650661679",
            "telephone_number": "573-437-7347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST MISSOURI BEHAVIORAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-31",
        "last_updated": "2010-05-04",
        "status": "A",
        "authorized_official_last_name": "PRATTE",
        "authorized_official_first_name": "BARRON",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT CEO",
        "authorized_official_telephone_number": "573-431-0554",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PR PLUS CONTRACT PROVIDER NUMBER WITH DMH",
            "identifier": "ADA-SDA4200053",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southeast Missouri Community Treatment Center",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Owensville, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.