| Mentally Ill Kids In Distress | |
|
2891 S Pacific Ave Yuma AZ 85365-3512 | |
| (928) 344-1983 | |
| (928) 493-3976 |
| Full Name | Mentally Ill Kids In Distress |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2891 S Pacific Ave, Yuma, Arizona |
| Authorized Official Name and Position | Jeff Kazmierczak (CHIEF EXECUTIVE OFFICER) |
| 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 2891 S Pacific Ave Yuma AZ 85365-3512 Ph: (928) 344-1983 |
| NPI Number | 1780008672 |
|---|---|
| Provider Enumeration Date | 02/12/2014 |
| Last Update Date | 06/02/2020 |
| Certification Date | 06/02/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780008672 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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