Northeast Family Health

LBN: Northeast Missouri Health Council Inc
Northeast Family Health is an health care organization with primary practice located at 1506 Crown Drive , Kirksville MO 63501. The organization recently has 4 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Allopathic & Osteopathic Physicians / Family Medicine, Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC), Physician Assistants & Advanced Practice Nursing Providers / Family. Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) is the primary health care specialty. Northeast Missouri Health Council Inc can be contacted via phone (660) 627-4493, or through Grimm, Andrew H via phone (660) 627-5757.

Contact Information

Primary practice address
1506 Crown Drive Kirksville MO 63501
Phone: (660) 627-4493
Fax: (660) 627-4288
Website:
Map and Directions
Authorized official contact:
Name: Grimm, Andrew H
Phone: (660) 627-5757

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 002241 Missouri
Behavioral Health & Social Service Providers / Clinical 1041C0700X 2006005622 Missouri
Behavioral Health & Social Service Providers / Clinical 1041C0700X 2005037424 Missouri
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X R5E64 Missouri
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X R5N07 Missouri
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 111208 Missouri
Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) 261QF0400X Missouri
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 096968 Missouri

Profile Details

NPI number 1962548974
LBN Legal business name Northeast Missouri Health Council Inc
DBA Doing business as Northeast Family Health
Authorized official Grimm, Andrew H
Entity Organization
Organization subpart 1 No
Enumeration date Jan 29th, 2007
Last updated Jun 24th, 2011 - about 13 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1962548974 NPPES
Missouri MEDICAID 503351843

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