| Mentally Ill Kids In Distress | |
|
1777 N Frank Reed Rd Suite 1 & 2 Nogales AZ 85621-4031 | |
| (602) 253-1240 | |
| Not Available |
| Full Name | Mentally Ill Kids In Distress |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1777 N Frank Reed Rd, Nogales, Arizona |
| Authorized Official Name and Position | Jeff Kazmierczak (CEO) |
| Authorized Official Contact | 6022531240 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mentally Ill Kids In Distress 7816 N 19th Ave Phoenix AZ 85021-7036 Ph: (602) 253-1240 | Mentally Ill Kids In Distress 1777 N Frank Reed Rd Suite 1 & 2 Nogales AZ 85621-4031 Ph: (602) 253-1240 |
| NPI Number | 1982150876 |
|---|---|
| Provider Enumeration Date | 08/30/2016 |
| Last Update Date | 08/14/2024 |
| Certification Date | 08/14/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982150876 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | OTC7759 (Arizona) | Primary |
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