Organization
DCCCA, INC
Active
Parent organization
DCCCA, INC
Other names
DCCCA Behavioral Health Wichita
Organization subpart
Yes
Provider details
NPI number
Legal business name
DCCCA, INC
Authorized official
KERYE J. JACKSON CPA, CMA (CFO)
(785) 841-4138
Entity
Organization
Contact information
Practice address
8901 E ORME ST, WICHITA, KS 67207-2473
(316) 262-0505
(316) 262-7384
Mailing address
3312 CLINTON PKWY, LAWRENCE, KS 66047-3624
(785) 841-4138
(785) 841-5777
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
KS
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100106740L
—
KS
Enumeration date
05/10/2007
Last updated
05/28/2020
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