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714 Front St Leadville CO 80461-3921 | |
| (719) 486-0985 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 714 Front St, Leadville, Colorado |
| Authorized Official Name and Position | Mandy Jo Kaisner (CEO) |
| Authorized Official Contact | 7192752351 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
3225 Independence Rd Canon City CO 81212-9380 Ph: (719) 275-2351 | 714 Front St Leadville CO 80461-3921 Ph: (719) 486-0985 |
| NPI Number | 1912420662 |
|---|---|
| Provider Enumeration Date | 07/24/2017 |
| Last Update Date | 05/09/2024 |
| Certification Date | 05/09/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912420662 | NPI | - | NPPES |
| 04200093 | Medicaid | CO |
Susanne Neal Dba Clearwater Counseling Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1206 Harrison Ave, Leadville, CO 80461 Phone: 719-293-0750 | |
Colorado Autism Consultants, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1609 Poplar St, Leadville, CO 80461 Phone: 720-584-8055 Fax: 303-957-2251 | |
Colorado Autism Consultants, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1609 Poplar St, Leadville, CO 80461 Phone: 719-584-8055 Fax: 303-957-2251 | |