| Mission Possible | |
|
1520 N Union Blvd Ste 204 Colorado Springs CO 80909-2840 | |
| (719) 635-9100 | |
| Not Available |
| Full Name | Mission Possible |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 1520 N Union Blvd Ste 204, Colorado Springs, Colorado |
| Authorized Official Name and Position | Palmer W Johnson (DIRECTOR) |
| Authorized Official Contact | 7196359100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mission Possible Po Box 9100 Colorado Springs CO 80932-0100 Ph: (719) 635-9100 | Mission Possible 1520 N Union Blvd Ste 204 Colorado Springs CO 80909-2840 Ph: (719) 635-9100 |
| NPI Number | 1477064590 |
|---|---|
| Provider Enumeration Date | 10/16/2017 |
| Last Update Date | 04/28/2021 |
| Certification Date | 04/28/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477064590 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 991344 (Colorado) | Primary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
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