Provider Demographics
NPI:1386774412
Name:AREA COMMUNITY HEALTH EMISSARIES, INC.
Entity type:Organization
Organization Name:AREA COMMUNITY HEALTH EMISSARIES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:GRANT MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PHYLLIS
Authorized Official - Middle Name:C
Authorized Official - Last Name:JAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:417-845-2243
Mailing Address - Street 1:PO BOX 1136
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:MO
Mailing Address - Zip Code:64831-1136
Mailing Address - Country:US
Mailing Address - Phone:417-845-2243
Mailing Address - Fax:417-845-2533
Practice Address - Street 1:508 W 76 HWY
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:MO
Practice Address - Zip Code:64831
Practice Address - Country:US
Practice Address - Phone:417-845-2243
Practice Address - Fax:417-845-2533
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-07
Last Update Date:2016-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO1101223D0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223D0001XDental ProvidersDentistDental Public HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO749331708Medicaid
MO748308707Medicaid
MO407479906Medicaid
MO401467311Medicaid
MO401786215Medicaid