OrganizationActive
Southeast, Inc
NPI 1114893203 · Federally Qualified Health Center (FQHC) · Mount Gilead, OH
Provider details
- NPI number
- 1114893203
- Entity type
- Organization
- Primary specialty
- Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
- Parent organization
- Southeast, Inc
- Organization subpart
- Yes
- Authorized official
- Charles Tong, Cfo(614) 813-0177
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Established profile(54/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
Under 1 yr in registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
950 Meadow Dr Ste D
Mount Gilead, OH 43338-1389
Phone: (419) 949-2000
Fax: (419) 751-7322
Street-level locationGet directions
Mailing address
950 Meadow Dr Ste D
Mount Gilead, OH 43338-1389
Registry dates
- Enumerated
- 2025-10-15
- Last updated
- 2026-01-16
- Certified
- 2026-01-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.