Southeast Mo Mental Health Center

LBN: State Of Missouri
Southeast Mo Mental Health Center is an health care organization with primary practice located at 1010 W Columbia St , Farmington MO 63640-2902. The organization recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Allopathic & Osteopathic Physicians / Psychiatry, Allopathic & Osteopathic Physicians / General Practice. Allopathic & Osteopathic Physicians / Psychiatry is the primary health care specialty. State Of Missouri can be contacted via phone (573) 218-6792, or through Boeckmann, Molly Jane via phone (573) 751-4055.

Contact Information

Primary practice address
1010 W Columbia St Farmington MO 63640-2902
Phone: (573) 218-6792
Fax: (573) 218-6703
Website:
Map and Directions
Authorized official contact:
Name: Boeckmann, Molly Jane
Phone: (573) 751-4055

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X
Behavioral Health & Social Service Providers / Clinical 1041C0700X
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X
Allopathic & Osteopathic Physicians / General Practice 208D00000X

Profile Details

NPI number 1437106705
LBN Legal business name State Of Missouri
DBA Doing business as Southeast Mo Mental Health Center
Authorized official Boeckmann, Molly Jane
Entity Organization
Organization subpart 1 Yes
Enumeration date May 30th, 2006
Last updated Sep 3rd, 2020 - about 5 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 1437106705 NPPES
Missouri MEDICAID 500490206

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