| Dccca, Inc. | |
|
501 S Ninnescah St Pratt KS 67124-2838 | |
| (620) 672-7546 | |
| (620) 672-7148 |
| Full Name | Dccca, Inc. |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 501 S Ninnescah St, Pratt, Kansas |
| Authorized Official Name and Position | Kerye J Jackson (CFO) |
| Authorized Official Contact | 7858414138 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dccca, Inc. 3312 Clinton Pkwy Lawrence KS 66047-3624 Ph: (785) 841-4138 | Dccca, Inc. 501 S Ninnescah St Pratt KS 67124-2838 Ph: (620) 672-7546 |
| NPI Number | 1932664190 |
|---|---|
| Provider Enumeration Date | 02/01/2019 |
| Last Update Date | 05/29/2020 |
| Certification Date | 05/29/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932664190 | NPI | - | NPPES |
| 200655670T | Medicaid | KS |
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