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 |
Location | 1520 N Union Blvd Ste 204, Colorado Springs, Colorado |
Authorized Official Name and Position | Palmer Johnson (LCSW) |
Authorized Official Contact | 7194929100 |
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: () - | Mission Possible 1520 N Union Blvd Ste 204 Colorado Springs CO 80909-2840 Ph: (719) 635-9100 |
NPI Number | 1982242970 |
---|---|
Provider Enumeration Date | 12/20/2019 |
Last Update Date | 12/20/2019 |
Certification Date | 12/20/2019 |
Identifier | Type | State | Issuer |
---|---|---|---|
1982242970 | NPI | - | NPPES |
9000156387 | Medicaid | CO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
104100000X | Social Worker | (* (Not Available)) | Primary |
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