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Organization

DCCCA, INC

Active
Parent organization
DCCCA, INC
Other names
DCCCA Behavioral Health Pittsburg
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
1102 S ROUSE ST, PITTSBURG, KS 66762-6048
(620) 231-9840
(620) 231-9893
Mailing address
3312 CLINTON PKWY, LAWRENCE, KS 66047-3624
(785) 841-4138
(785) 841-3642

Taxonomy

Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100106740N
KS
Enumeration date
11/11/2010
Last updated
05/27/2020
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