Provider Demographics
NPI:1083770986
Name:NORTH EAST COMMUINTY ACTION CORP
Entity Type:Organization
Organization Name:NORTH EAST COMMUINTY ACTION CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:D
Authorized Official - Last Name:PATRICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-324-2231
Mailing Address - Street 1:PO BOX 470
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:MO
Mailing Address - Zip Code:63334
Mailing Address - Country:US
Mailing Address - Phone:573-324-2231
Mailing Address - Fax:573-324-3960
Practice Address - Street 1:16 NORTH COURT STREET
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:MO
Practice Address - Zip Code:63334
Practice Address - Country:US
Practice Address - Phone:573-324-2231
Practice Address - Fax:573-324-3960
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-28
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty
No253Z00000XAgenciesIn Home Supportive CareGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO281920504Medicaid