| Dccca, Inc | |
|
12351 W 96th Ter Suite 300 Lenexa KS 66215-4409 | |
| (913) 894-0900 | |
| (913) 894-0908 |
| Full Name | Dccca, Inc |
|---|---|
| Speciality | Clinic/center - Rehabilitation, Substance Use Disorder |
| Location | 12351 W 96th Ter, Lenexa, 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: (913) 894-0900 | Dccca, Inc 12351 W 96th Ter Suite 300 Lenexa KS 66215-4409 Ph: (913) 894-0900 |
| NPI Number | 1043414022 |
|---|---|
| Provider Enumeration Date | 06/13/2007 |
| Last Update Date | 05/29/2020 |
| Certification Date | 05/29/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043414022 | NPI | - | NPPES |
| 00590942 | Other | KS | AAPS |
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