| Mentally Ill Kids In Distress | |
|
365 Short St Sierra Vista AZ 85635-1918 | |
| (520) 351-9002 | |
| (602) 840-3409 |
| Full Name | Mentally Ill Kids In Distress |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 365 Short St, Sierra Vista, Arizona |
| Authorized Official Name and Position | Jeff Kazmierczak (CEO) |
| 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 365 Short St Sierra Vista AZ 85635-1918 Ph: (520) 351-9002 |
| NPI Number | 1902116312 |
|---|---|
| Provider Enumeration Date | 10/19/2010 |
| Last Update Date | 06/16/2025 |
| Certification Date | 06/16/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902116312 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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