Provider Demographics
NPI:1689699837
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:CEO
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:316-266-8722
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 1:1220 E 1ST ST N
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67214-3907
Practice Address - Country:US
Practice Address - Phone:316-266-8717
Practice Address - Fax:316-266-8757
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-12
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSA-085-010251E00000X, 385H00000X
KSA-068-002251E00000X, 385H00000X
KSA-089-031251E00000X, 385H00000X
KSA-050-007251E00000X, 385H00000X
NEHHA200609251E00000X
251E00000X
KSA-087-046385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100066570FMedicaid
KS100007090CMedicaid
KS100066570GMedicaid
NE10025453800Medicaid
KS30003931500027Medicaid
KS30003931500005Medicaid
KS100066570CMedicaid
KS100007090EMedicaid
KS30003931500007Medicaid
KS100007090AMedicaid
KS100007090FMedicaid
KS30003931500004Medicaid
KS300039315000013Medicaid
KS30003931500006Medicaid
MO945429900Medicaid