Provider Demographics
NPI:1689699837
Name:CRAIG RESOURCES LLC
Entity type:Organization
Organization Name:CRAIG RESOURCES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP OF QUALITY & COM PLIANCE
Authorized Official - Prefix:
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:A
Authorized Official - Last Name:BULMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-789-0926
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:316-264-9988
Practice Address - Fax:316-264-0016
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-12
Last Update Date:2025-03-13
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, 385H00000X
KSA-087-046385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100066570CMedicaid
KS30003931500011Medicaid
MO945429900Medicaid
KS100007090EMedicaid
KS100066570FMedicaid
NE10025453800Medicaid
KS100007090AMedicaid
KS30003931500027Medicaid
KS100007090CMedicaid
KS100007090FMedicaid
NE10026433800Medicaid
KS30003931500004Medicaid
KS30003931500006Medicaid
KS30003931500007Medicaid
MO945429900Medicaid