DCCCA, INC (NPI# 1336329911) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336329911 |
| Entity Type | Organization |
| Organization Name | DCCCA, INC |
| Other Organization Name | DCCCA, GREAT BEND ADDICTION SERVICES |
| Practice Address |
2110 Kansas Ave Great Bend KS 67530-2516 |
| Mailing Address |
3312 Clinton Pkwy Lawrence KS 66047-3624 |
| Practice Telephone | 6207924665 |
| Practice Fax Number | 6207922445 |
| Mailing Telephone | 7858414138 |
| Mailing Fax Number | 7858415777 |
| Enumeration Date | 2007-11-12 |
| Last Update Date | 2020-05-29 |
| Authorized Official Name | KERYE J. JACKLSON (CFO) |
| Authorized Official Telephone | 7858414138 |
| Authorized Official Credential | CPA, CMA, MBA |
| Is Organization Subpart | Y |
| Parent Organization Name | DCCCA, INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
678 | KS | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| DCCCA, Great Bend Addiction Services | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558632299 | Dccca, Inc | Case Management | 3517 Lake Rd, Ponca City, OK 74604-5168 | 2012-01-25 |
| 1417280611 | Dccca, Inc | Case Management | 700 N Market St, Wichita, KS 67214-3518 | 2009-09-08 |
| 1932228533 | Dccca, Inc | Clinic/Center | 1319 W May St, Suite 1319b, Wichita, KS 67213-3505 | 2007-03-28 |
| 1609994359 | Dccca, Inc | Substance Abuse Rehabilitation Facility | 1410 N Vine St, Hoisington, KS 67544-1557 | 2007-03-27 |
| 1356469209 | Dccca, Inc | Substance Abuse Rehabilitation Facility | 3015 W 31st St, Lawrence, KS 66047-3042 | 2007-03-27 |
| 1215055090 | Dccca, Inc | Clinic/Center | 501 W Central St, Columbus, KS 66725-9211 | 2007-03-27 |
| 1932227683 | Dccca, Inc | Substance Abuse Rehabilitation Facility | 2930 Sw Wanamaker Dr, Topeka, KS 66614-4116 | 2007-03-27 |
| 1477646073 | Dccca, Inc | Case Management | 501 S. Ninnescah, Pratt, KS 67124-2838 | 2006-10-02 |
| 1861793556 | Dccca, Inc | Case Management | 1102 S Rouse St, Pittsburg, KS 66762-6048 | 2010-11-11 |
| 1053551663 | Dccca, Inc | Case Management | 121 College St, Winfield, KS 67156-2442 | 2009-02-23 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | DCCCA, INC. | 3312 Clinton Pkwy, Lawrence, KS 66047-3624 |
| Colorado Business Entities | DCCCA, INC. | 3312 Clinton Pkwy, Lawrence, KS 66047 |
| Street Address |
2110 KANSAS AVE |
| City | GREAT BEND |
| State | KS |
| Zip Code | 67530-2516 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609488048 | Taryn Mitchell | Pharmacist | 3910 10th St, Great Bend, KS 67530 | 2020-08-18 |
| 1972113678 | Sarah Schenek | Counselor | 1819 11th Street, Great Bend, KS 67530 | 2020-08-06 |
| 1407471840 | Joanne Renee Wondra | Counselor | 801 Patton Road, Great Bend, KS 67530 | 2020-06-11 |
| 1144852302 | Rosenberg Dentistry: Joe Rosenberg Dds. Pa | Dentist | 1037 Sheridan Suite D, Great Bend, KS 67530 | 2020-02-06 |
| 1265895908 | Kayti Trapp | Physical Therapy Assistant | 1514 Ks-96 Hwy, Great Bend, KS 67530 | 2016-03-31 |
| 1083732069 | Drew Andrew Hosman Sr. | Counselor | 1105 Main St Ste D, Great Bend, KS 67530 | 2007-03-27 |
| 1912060435 | Larry G Kutina | Dentist | 3820 6th Street, Great Bend, KS 67530 | 2006-12-18 |
| 1144308883 | Hcc-healthcare of Great Bend, LLC | Skilled Nursing Facility | 1560 K96 Highway, Great Bend, KS 67530 | 2006-11-01 |
| 1841370699 | Edward Lake Jones | Pathology | 2001 Lincoln, Great Bend, KS 67530 | 2006-10-16 |
| 1407955529 | William G Hafner | Chiropractor | 1309 Williams St., Great Bend, KS 67530 | 2006-09-22 |
| Find all providers in zip 67530 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881173334 | Pmr, Pa | Clinic/Center | 7301 Mission Rd Ste 135, Prairie Village, KS 66208-3005 | 2018-08-07 |
| 1982000303 | Doolittle & Harrington Healthcare LLC | Clinic/Center | 10560 Barkley St Ste 340, Overland Park, KS 66212 | 2014-11-12 |
| 1871833285 | Changing Habits | Clinic/Center | 1115 S Glendale St Ste 204, Parklane Shopping Center Lower Level, Wichita, KS 67218-3232 | 2013-02-21 |
| 1952532202 | The Human Enhancement Learning Program of Servants Inc. | Clinic/Center | 400 N 6th St, Kansas City, KS 66101-3135 | 2009-08-05 |
| 1184878043 | Assessment for Direction | Clinic/Center | 2404 Se Kentucky Ave, Topeka, KS 66605-1379 | 2008-11-05 |
| 1518159938 | Finney County | Clinic/Center | 601 N Main St Ste A, Garden City, KS 67846-5468 | 2007-08-10 |
| 1477754836 | Thomas County Alcohol and Drug Abuse Council, Inc. | Clinic/Center | 1523 W 4th St, Colby, KS 67701-1542 | 2007-05-31 |
| 1821113663 | Knox Center, Inc. | Clinic/Center | 2924 E Douglas Ave, Wichita, KS 67214-4709 | 2007-03-20 |
| 1114065489 | Substance Abuse Assessment Ctr | Clinic/Center | 731 N Water St, Ste 2, Wichita, KS 67203-3853 | 2007-02-01 |
| 1790879534 | New Freedom Inc | Clinic/Center | 1600 Skyway, Atchison, KS 66002 | 2006-10-03 |
| Find all providers with the same taxonomy | ||||
| City | GREAT BEND |
| Zip Code | 67530 |
Please comment or provide details below to improve the information on DCCCA, INC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.