| Mikid | |
|
115 E Riverwalk Unit 110 Pueblo CO 81003-3308 | |
| (602) 252-1240 | |
| (602) 840-3409 |
| Full Name | Mikid |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 115 E Riverwalk Unit 110, Pueblo, Colorado |
| 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 |
|---|---|
| Mikid 7816 N 19th Ave Phoenix AZ 85021-7036 Ph: (602) 253-1240 | Mikid 115 E Riverwalk Unit 110 Pueblo CO 81003-3308 Ph: (602) 252-1240 |
| NPI Number | 1336800341 |
|---|---|
| Provider Enumeration Date | 01/03/2022 |
| Last Update Date | 08/14/2024 |
| Certification Date | 08/14/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336800341 | NPI | - | NPPES |
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