| Hawthorne Mental Health Llc | |
|
503 N Main St Ste 658 Pueblo CO 81003-3132 | |
| (719) 644-5573 | |
| Not Available |
| Full Name | Hawthorne Mental Health Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 503 N Main St Ste 658, Pueblo, Colorado |
| Authorized Official Name and Position | Geofrey Kosgei (MANAGER) |
| Authorized Official Contact | 7195027832 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Hawthorne Mental Health Llc 7217 Alpine Daisy Dr Colorado Springs CO 80925-9611 Ph: (719) 502-7832 | Hawthorne Mental Health Llc 503 N Main St Ste 658 Pueblo CO 81003-3132 Ph: (719) 644-5573 |
| NPI Number | 1396510426 |
|---|---|
| Provider Enumeration Date | 11/20/2023 |
| Last Update Date | 11/20/2023 |
| Certification Date | 11/18/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396510426 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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