| Crittenton Center | |
|
3901 Green Ave Sioux City IA 51106-5346 | |
| (712) 255-4321 | |
| (712) 252-4743 |
| Full Name | Crittenton Center |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 3901 Green Ave, Sioux City, Iowa |
| Authorized Official Name and Position | Beau Sudtelgte (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 7122554321 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Crittenton Center 600 4th St Ste 100 Sioux City IA 51101-1745 Ph: (712) 255-4321 | Crittenton Center 3901 Green Ave Sioux City IA 51106-5346 Ph: (712) 255-4321 |
| NPI Number | 1861276123 |
|---|---|
| Provider Enumeration Date | 08/18/2023 |
| Last Update Date | 08/22/2023 |
| Certification Date | 08/22/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861276123 | NPI | - | NPPES |
| 1295818334 | Medicaid | IA | |
| 1215070438 | Medicaid | IA | |
| 1205915261 | Medicaid | IA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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