NPIMap

Organization Active NPI

Mikid, Mentally Ill Kids in Distress

  • Community/Behavioral Health Agency
  • Yuma, AZ
National Provider Identifier
1801026539
Registry record updated Jul 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
CSA09ADHS0142 -2 Issued in AZ
Legal business name
MIKID, MENTALLY ILL KIDS IN DISTRESS
Practice address
100 E 24TH St
Yuma, AZ 85364-8619
Phone
(928) 726-2191
Fax
(928) 726-4052
NPI assigned
Jul 15, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Vicki L. Johnson
Title
Executive Director
Phone
(602) 253-1240

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X CSA09ADHS0142 -2 AZ Primary

Addresses

Primary practice location

100 E 24TH St
Yuma, AZ 85364-8619

Mailing address

2642 E Thomas Rd
Phoenix, AZ 85016-8202
Phone (602) 253-1240

National Provider Directory

National Provider Directory
Tax ID family
Mentally Ill Kids in Distress12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

Locations

100 E 24th St
Yuma, AZ 85364
Phone (520) 783-7181

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1247616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1247616000000",
    "number": "1801026539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2642 E THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850168202",
            "telephone_number": "602-253-1240",
            "fax_number": "602-253-1250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E 24TH ST",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853648619",
            "telephone_number": "928-726-2191",
            "fax_number": "928-726-4052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIKID, MENTALLY ILL KIDS IN DISTRESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-15",
        "last_updated": "2009-07-15",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "VICKI",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "602-253-1240"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "AZ",
            "license": "CSA09ADHS0142 -2",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yuma, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.