| Organization Name: | CHRISTIAN CARE COTTAGE |
| NPI Number: | 1013176221 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CAROLYN SUE RANDEL (OPERATOR) |
| Mailing Address: | 415 S Poplar St Ottawa |
| State: | KS US |
| Postal Code: | 660672438 |
| Phone Number: | 7852426383 |
| Fax Number: | 7852426059 |
| NPI Enumeration Date: | 06/03/2008 |
| NPI Last Update Date: | 03/15/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QH0100X |
| License Number: | 23-21195-021 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KS |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Health Service |
| Taxonomy Definition: | |