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General NPI Number Information
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NPI Number | 1447236575
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Entity Type | Organization
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Legal Business Name | SOUTHEAST HEALTH CENTER OF RIPLEY COUNTY
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Dates
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Enumeration Date | 12/20/2005
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Last Update Date | 03/12/2014
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Provider Practice Location Address
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Address Line | 208 N GRAND AVE
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City | DONIPHAN
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State | MO
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Zip | 63935-1768
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Country | US
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Telephone | 573-996-2141
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Fax | 573-996-4151
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Provider Business Mailing Address
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Address Line | 208 N GRAND AVE
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City | DONIPHAN
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State | MO
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Zip | 63935-1768
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Country | US
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Telephone | 573-996-2141
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Fax | 573-996-4151
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Authorized Official
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Title or Position | VP REGIONAL OPERATIONS
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Name | MRS. PAULA E HARRIS
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Credential |
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Telephone | 573-778-0020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 851-HH
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License Number State | MO
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