Provider Demographics
NPI:1821121534
Name:FLORENCE CRITTENTON SERVICES OF TOPEKA, INC.
Entity Type:Organization
Organization Name:FLORENCE CRITTENTON SERVICES OF TOPEKA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:JOLANA
Authorized Official - Middle Name:R
Authorized Official - Last Name:PINON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-233-0516
Mailing Address - Street 1:2649 SW ARROWHEAD RD
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66614-2458
Mailing Address - Country:US
Mailing Address - Phone:785-233-0516
Mailing Address - Fax:785-271-4433
Practice Address - Street 1:2649 SW ARROWHEAD RD
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66614-2458
Practice Address - Country:US
Practice Address - Phone:785-233-0516
Practice Address - Fax:785-271-4433
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2011-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QM0801X, 261QM0855X, 322D00000X
KS0003166-003323P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100385900BOtherKMAP ID