Organization
CRITTENTON CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BEAU SUDTELGTE ED.D. (CHIEF FINANCIAL OFFICER)
(712) 255-4321
Entity
Organization
Contact information
Practice address
3901 GREEN AVE, SIOUX CITY, IA 51106-5346
(712) 255-4321
(712) 252-4743
Mailing address
600 4TH ST STE 100, SIOUX CITY, IA 51101-1745
(712) 255-4321
(712) 252-4743
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1205915261
—
IA
05
—
1215070438
—
IA
05
—
1295818334
—
IA
Enumeration date
08/18/2023
Last updated
08/22/2023
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