Healthcare Provider Details

I. General information

NPI: 1164809869
Provider Name (Legal Business Name): CRAIG RESOURCES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2015
Last Update Date: 09/26/2022
Certification Date: 09/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5661 TELEGRAPH RD STE 5B
SAINT LOUIS MO
63129-4275
US

IV. Provider business mailing address

1220 E 1ST ST N
WICHITA KS
67214-3907
US

V. Phone/Fax

Practice location:
  • Phone: 314-843-0316
  • Fax: 316-843-0317
Mailing address:
  • Phone: 316-266-8717
  • Fax: 316-266-8757

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. SEAN BALKE
Title or Position: PRESIDENT & COO
Credential:
Phone: 162-668-7223