Provider Demographics
NPI:1275539744
Name:COTTONWOOD INCORPORATED
Entity Type:Organization
Organization Name:COTTONWOOD INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:S
Authorized Official - Last Name:SPRATT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-842-0550
Mailing Address - Street 1:2801 W 31ST ST
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66047-3049
Mailing Address - Country:US
Mailing Address - Phone:785-842-0550
Mailing Address - Fax:785-842-6102
Practice Address - Street 1:2801 W 31ST ST
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66047-3049
Practice Address - Country:US
Practice Address - Phone:785-842-0550
Practice Address - Fax:785-842-6102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS171WH0202X, 251E00000X, 332BC3200X, 3747P1801X
251B00000X, 251C00000X, 320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered171WH0202XOther Service ProvidersContractorHome ModificationsGroup - Multi-Specialty
Not Answered251B00000XAgenciesCase ManagementGroup - Multi-Specialty
Not Answered251C00000XAgenciesDay Training, Developmentally Disabled ServicesGroup - Multi-Specialty
Not Answered251E00000XAgenciesHome Health
Not Answered320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Not Answered332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Not Answered3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty