NPIMap

Organization Active NPI

Southeast Missouri Community Treatment Center Inc

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Poplar Bluff, MO
National Provider Identifier
1407917404
Registry record updated May 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
SOUTHEAST MISSOURI COMMUNITY TREATMENT CENTER INC
Practice address
101 S Main St
Poplar Bluff, MO 63901-5843
Phone
(573) 686-5090
Fax
(573) 785-4104
NPI assigned
Dec 13, 2006
Last updated
May 6, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2008

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 Primary

Addresses

Primary practice location

101 S Main St
Poplar Bluff, MO 63901-5843

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
866204605MedicaidMO

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

NPI Registry JSON

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210032000000",
    "number": "1407917404",
    "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": "101 S MAIN ST",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639015843",
            "telephone_number": "573-686-5090",
            "fax_number": "573-785-4104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST MISSOURI COMMUNITY TREATMENT CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-13",
        "last_updated": "2008-05-06",
        "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "866204605",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Poplar Bluff, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2008; 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.