DCCCA, INC. (NPI# 1932664190) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932664190 |
| Entity Type | Organization |
| Organization Name | DCCCA, INC. |
| Other Organization Name | DCCCA BEHAVIORAL HEALTH PRATT |
| Practice Address |
501 S Ninnescah St Pratt KS 67124-2838 |
| Mailing Address |
3312 Clinton Pkwy Lawrence KS 66047-3624 |
| Practice Telephone | 6206727546 |
| Practice Fax Number | 6206727148 |
| Mailing Telephone | 7858414138 |
| Mailing Fax Number | 7858415777 |
| Enumeration Date | 2019-02-01 |
| Last Update Date | 2020-05-29 |
| Authorized Official Name | KERYE J JACKSON (CFO) |
| Authorized Official Telephone | 7858414138 |
| Is Organization Subpart | Y |
| Parent Organization Name | DCCCA, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers | ||
| N | 251B00000X | Case Management | Agencies | ||
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KS | 200655670T | 05 |
| Other Name | Type Code |
|---|---|
| DCCCA Behavioral Health Pratt | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871797951 | Dccca, Inc. | Case Management | 503 N Walnut St, Pittsburg, KS 66762-3823 | 2007-06-13 |
| 1275737785 | Dccca, Inc. | Case Management | 119 Jones St, El Dorado, KS 67042-1469 | 2007-06-11 |
| 1578767075 | Dccca, Inc. | Case Management | 215 W Cherry St, Chanute, KS 66720-1756 | 2007-06-11 |
| 1417076001 | Dccca, Inc. | Case Management | 1102 South Rouse, Pittsburg, KS 66762-6023 | 2007-03-28 |
| 1467900357 | Dccca, Inc. | Foster Care Agency | 3312 Clinton Pkwy, Lawrence, KS 66047-3624 | 2016-09-20 |
| 1952505935 | Dccca, Inc. | Clinic/Center | 119 Jones St, El Dorado, KS 67042-1469 | 2007-06-13 |
| 1841494929 | Dccca, Inc. | Case Management | 3312 Clinton Pkwy, Lawrence, KS 66047-3624 | 2007-06-13 |
| 1740484260 | Dccca, Inc. | Case Management | 1101 Donald Ave, Independence, KS 67301-2001 | 2007-06-11 |
| 1629272042 | Dccca, Inc. | Case Management | 12351 W 96th Ter, Suite 300, Lenexa, KS 66215-4409 | 2007-06-11 |
| 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 |
| Oklahoma Business Registrations | DCCCA, INC. | 3312 Clinton Parkway, Lawrence, KS 66047 |
| Street Address |
501 S NINNESCAH ST |
| City | PRATT |
| State | KS |
| Zip Code | 67124-2838 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457885204 | Tamara Leaann Johnston | Counselor | 501 S Ninnescah St, Pratt, KS 67124-2838 | 2017-04-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487270013 | Americare At Grand Plains Skilled Nursing and Rehabiltation LLC | Skilled Nursing Facility | 331 State Route 61, Pratt, KS 67124 | 2020-06-19 |
| 1275025264 | Steven M Kunz | Dentist | 501 S. Fincham, Pratt, KS 67124 | 2018-06-05 |
| 1972046266 | Hillary Sims | Developmental Therapist | 216 Curtis St., Pratt, KS 67124 | 2016-11-18 |
| 1215216122 | Kelli Gallagher | Occupational Therapist | 707 S High, Pratt, KS 67124 | 2011-08-09 |
| 1417193301 | Pratt Regional Medical Center Corp | Nurse Anesthetist, Certified Registered | 200 Commodore, Pratt, KS 67124 | 2008-12-23 |
| 1861511891 | Corey L. Neal | Specialist/Technologist | 348 Ne Sr 61, Pratt, KS 67124 | 2007-03-29 |
| 1588757454 | Dave J Johnston | Dentist | 219 S Ninnescah, Pratt, KS 67124 | 2006-10-02 |
| 1518060995 | William David Eastes | Chiropractor | 223 E 4th, Pratt, KS 67124 | 2006-09-07 |
| 1376646620 | Luis E Espinoza | Specialist | 124 Commodore St Ste B, Pratt, KS 67124 | 2006-09-05 |
| 1205809605 | John D Mathes | Dentist | 603 N Main, Pratt, KS 67124 | 2006-02-08 |
| Find all providers in zip 67124 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
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| 1538642509 | Restoration Family Counseling Services | Clinic/Center | 5120 E Central Ave Ste 1, Wichita, KS 67208-4168 | 2018-09-14 |
| 1467939124 | Alleviation Behavioral Health Care, LLC | Clinic/Center | 4123b Sw Twilight Dr, Topeka, KS 66614-3403 | 2018-07-25 |
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| 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.