Mikid, Mentally Ill Kids In Distress

LBN: Mikid, Mentally Ill Kids In Distress
Mikid, Mentally Ill Kids In Distress is an health care organization with primary practice located at 755 E Willetta St Ste 128, Phoenix AZ 85006-2723. The organization recently has only one registered license in Agencies / Voluntary or Charitable, which is considered as the primary health care specialty. Mikid, Mentally Ill Kids In Distress can be contacted via phone (602) 253-1240, or through Johnson, Vicki Lynn via phone (602) 253-1240.

Contact Information

Primary practice address
755 E Willetta St Ste 128 Phoenix AZ 85006-2723
Phone: (602) 253-1240
Fax: (602) 253-1250
Website:
Map and Directions
Authorized official contact:
Name: Johnson, Vicki Lynn Master of Arts (MA)
Phone: (602) 253-1240

Health care specialties

SpecialtyCodeLicense #State
Agencies / Voluntary or Charitable 251V00000X CSA05VO0142 Arizona

Profile Details

NPI number 1922036599
LBN Legal business name Mikid, Mentally Ill Kids In Distress
DBA Doing business as
Authorized official Johnson, Vicki Lynn Master of Arts (MA)
Entity Organization
Organization subpart 1 No
Enumeration date Jun 30th, 2006
Last updated Aug 22nd, 2020 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1922036599 NPPES
Arizona MEDICAID 757114

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