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Organization
DCCCA, INC.
Active
Organization
DCCCA, INC.
Active
Parent organization
DCCCA, INC.
Other names
DCCCA Behavioral Health Pratt
Organization subpart
Yes
Provider details
NPI number
Legal business name
DCCCA, INC.
Authorized official
KERYE J JACKSON (CFO)
(785) 841-4138
Entity
Organization
Contact information
Practice address
501 S NINNESCAH ST, PRATT, KS 67124-2838
(620) 672-7546
(620) 672-7148
Mailing address
3312 CLINTON PKWY, LAWRENCE, KS 66047-3624
(785) 841-4138
(785) 841-5777
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
251B00000X
Case Management Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200655670T
—
KS
Enumeration date
02/01/2019
Last updated
05/29/2020
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