Provider Demographics
NPI:1386744696
Name:MCCRITE RETIREMENT ASSOCIATION
Entity type:Organization
Organization Name:MCCRITE RETIREMENT ASSOCIATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:I
Authorized Official - Last Name:MCCRITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-267-2960
Mailing Address - Street 1:1610 SW 37TH ST
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66611-2564
Mailing Address - Country:US
Mailing Address - Phone:785-267-2960
Mailing Address - Fax:785-267-0138
Practice Address - Street 1:1610 SW 37TH ST
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66611-2564
Practice Address - Country:US
Practice Address - Phone:785-267-2960
Practice Address - Fax:785-267-0138
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
310400000X
KSN089010314000000X, 332BN1400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100108050AMedicaid
KS0000000336OtherBLUE CROSS BLUE SHIELD