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NPI Code Detail

MEDICARE: SOUTHEAST, INC

MEDICARE: SOUTHEAST, INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251B00000XCase Management Agency6723, 3040OH
2261Q00000XClinic/Center
3261QM0850XAdult Mental Health Clinic/Center0300OH
4320800000XMental Illness Community Based Residential Treatment Facility0300OH
5261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)0300OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1932169497
Entity Type Code : Organization
Provider Name (Legal Business Name) : SOUTHEAST, INC
Provider Business Mailing Address
First Line : 16 W LONG ST
Second Line :
City : COLUMBUS
State : OH
Zip : 43215-2815
Country : US
Telephone Number : 614-225-0980
Fax Number : 614-225-0986
Provider Business Practice Location Address
First Line : 16 W LONG ST
Second Line :
City : COLUMBUS
State : OH
Zip : 43215-2815
Country : US
Telephone Number : 614-225-0980
Fax Number : 614-225-0986
Authorized Official
Title or Position : CFO
Name : MR. CHARLES TONG
Credential :
Telephone Number : 614-225-0980
Provider Enumeration Date : 03/27/2006
Last Update Date : 10/19/2025

Similar Medicare Providers

1063406106 — DR. STEVEN F. BREZNY MD
Practice Location Address:
16 W LONG ST
COLUMBUS, OH
43215-2815
Practice Phone: 614-225-0990
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1700836483 — MS. MARY ANN KLEE LISW
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43215-2815
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1760435192 — MR. ARTHUR RICHARD REYNOLDS MSW
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COLUMBUS, OH
43215-2815
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1538114111 — MS. SANDRA SCHRIER STEPHENSON LPCC, LISW
Practice Location Address:
16 W LONG ST
COLUMBUS, OH
43215-2815
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Practice Fax: 614-225-0986
1467499756 — MS. MARGARET JACKSON HALL MSW, LISW
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COLUMBUS, OH
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Practice Fax: 614-225-0986
1699714774 — DANIEL JOE BLOCH MD
Practice Location Address:
16 W LONG ST
COLUMBUS, OH
43215-2815
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Directions to “SOUTHEAST, INC ” Practice Location

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