Provider Demographics
NPI:1356491955
Name:NORTH EAST COMMUNITY ACTION CORP
Entity Type:Organization
Organization Name:NORTH EAST COMMUNITY ACTION CORP
Other - Org Name:NECAC FAMILY PLANNING CENTER AND NECAC HEALTH SERVICES
Other - Org Type:Other Name
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 2:16 NORTH COURT
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 1:24 NORTHPORT PLZ
Practice Address - Street 2:
Practice Address - City:HANNIBAL
Practice Address - State:MO
Practice Address - Zip Code:63401-2269
Practice Address - Country:US
Practice Address - Phone:573-221-3404
Practice Address - Fax:573-221-0640
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-12
Last Update Date:2009-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0050XAmbulatory Health Care FacilitiesClinic/CenterFamily Planning, Non-Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO522963503Medicaid