Provider Demographics
NPI:1376765875
Name:CRITTENTON
Entity Type:Organization
Organization Name:CRITTENTON
Other - Org Name:CRITTENTON CHILDREN'S CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JANINE
Authorized Official - Middle Name:M
Authorized Official - Last Name:HRON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:816-765-6600
Mailing Address - Street 1:10918 ELM AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64134-4108
Mailing Address - Country:US
Mailing Address - Phone:816-765-6600
Mailing Address - Fax:
Practice Address - Street 1:10918 ELM AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64134-4108
Practice Address - Country:US
Practice Address - Phone:816-765-6600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CRITTENTON
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-05-03
Last Update Date:2014-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No207QA0000XAllopathic & Osteopathic PhysiciansFamily MedicineAdolescent MedicineGroup - Multi-Specialty
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Multi-Specialty
No283Q00000XHospitalsPsychiatric HospitalGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO507576700Medicaid