Provider Demographics
NPI:1164809869
Name:CRAIG RESOURCES, INC.
Entity Type:Organization
Organization Name:CRAIG RESOURCES, INC.
Other - Org Name:CRAIG HOMECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT & COO
Authorized Official - Prefix:MR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BALKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:162-668-7223
Mailing Address - Street 1:1220 E 1ST ST N
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67214-3907
Mailing Address - Country:US
Mailing Address - Phone:316-266-8717
Mailing Address - Fax:316-266-8757
Practice Address - Street 1:5661 TELEGRAPH RD STE 5B
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63129-4275
Practice Address - Country:US
Practice Address - Phone:314-843-0316
Practice Address - Fax:316-843-0317
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-01
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO945429900Medicaid
MO0009412OtherS SBG/GR
MO265429902OtherMEDICAID PERSONAL CARE