DCCCA, INC


Address: 2110 Kansas Ave, Great Bend, KS 67530-2516
Phone: 6207924665

DCCCA, INC (NPI# 1336329911) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

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

Taxonomy

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 Provider/Organization Names

Other Name Type Code
DCCCA, Great Bend Addiction Services Doing Business As Name - Organization

Other Provider IDs and Locations

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

Other Data Sources

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

Office Location

Street Address 2110 KANSAS AVE
City GREAT BEND
State KS
Zip Code 67530-2516

Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 261QR0405X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Rehabilitation, Substance Use Disorder

Taxonomy Definition

Definition to come...

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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
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Competitor

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City GREAT BEND
Zip Code 67530

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Dataset Information

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.

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