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General NPI Number Information
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NPI Number | 1144293549
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Entity Type | Organization
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Legal Business Name | EAST CENTRAL MISSOURI BEHAVIORAL HEALTH SERVICES, INC
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Dates
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Enumeration Date | 02/08/2006
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Last Update Date | 12/12/2024
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Provider Practice Location Address
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Address Line | 340 KELLEY PARKWAY
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City | MEXICO
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State | MO
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Zip | 65265-2719
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Country | US
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Telephone | 573-582-1234
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Fax | 573-581-1981
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Provider Business Mailing Address
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Address Line | 340 KELLEY PARKWAY
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City | MEXICO
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State | MO
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Zip | 65265-2719
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Country | US
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Telephone | 573-582-1234
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Fax | 573-581-1981
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Authorized Official
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Title or Position | DIRECTOR OF COMPLIANCE
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Name | JEANANN EARLY
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Credential |
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Telephone | 573-582-1234
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | 5726-7685
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License Number State | MO
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