Provider Demographics
NPI:1215900899
Name:COUNTY OF CRAWFORD
Entity type:Organization
Organization Name:COUNTY OF CRAWFORD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:STACY
Authorized Official - Middle Name:L
Authorized Official - Last Name:KRATZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-231-5130
Mailing Address - Street 1:911 E CENTENNIAL DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURG
Mailing Address - State:KS
Mailing Address - Zip Code:66762-6601
Mailing Address - Country:US
Mailing Address - Phone:620-231-5130
Mailing Address - Fax:620-235-7101
Practice Address - Street 1:911 E CENTENNIAL DR
Practice Address - Street 2:
Practice Address - City:PITTSBURG
Practice Address - State:KS
Practice Address - Zip Code:66762-6601
Practice Address - Country:US
Practice Address - Phone:620-231-5130
Practice Address - Fax:620-235-7101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-13
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS10091610EMedicaid
00132OtherBCBS
KS100091610CMedicaid
KS100091610JMedicaid
00847OtherBCBS
000067OtherBCBS
KS100091610GMedicaid
KS100091610GMedicaid