MIKID, MENTALLY ILL KIDS IN DISTRESS (NPI# 1902116312) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902116312 |
| Entity Type | Organization |
| Organization Name | MIKID, MENTALLY ILL KIDS IN DISTRESS |
| Practice Address |
2957 N Us Highway 89 Prescott AZ 86301-4963 |
| Mailing Address |
2642 E Thomas Rd Phoenix AZ 85016-8202 |
| Practice Telephone | 9287104610 |
| Practice Fax Number | 9286369904 |
| Mailing Telephone | 6022531240 |
| Mailing Fax Number | 6022531250 |
| Enumeration Date | 2010-10-19 |
| Last Update Date | 2010-10-19 |
| Authorized Official Name | MS. VICKI LYNN JOHNSON (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 6022531240 |
| Authorized Official Credential | M.A. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 385HR2055X |
Respite Care Specialization: Respite Care, Mental Illness, Child |
Respite Care Facility |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801026539 | Mikid, Mentally Ill Kids In Distress | Community/Behavioral Health | 100 E 24th St, Yuma, AZ 85364-8619 | 2009-07-15 |
| 1922036599 | Mikid, Mentally Ill Kids In Distress | Voluntary or Charitable | 755 E Willetta St, Ste 128, Phoenix, AZ 85006-2723 | 2006-06-30 |
| 1144554197 | Mikid, Mentally Ill Kids In Distress | Community/Behavioral Health | 367 N Main St, Suite 4, Eagar, AZ 85925-9675 | 2009-09-23 |
| 1891701280 | Mikid, Mentally Ill Kids In Distress | Voluntary or Charitable | 755 E Willetta St, Ste. 128, Phoenix, AZ 85006-2723 | 2006-07-31 |
| Street Address |
2957 N US HIGHWAY 89 |
| City | PRESCOTT |
| State | AZ |
| Zip Code | 86301-4963 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568658599 | Ascend Autism Spectrum Center for Educational and Neurological Develop | Local Education Agency (LEA) | 2957 N Us Highway 89, Suite B & C, Prescott, AZ 86301-4963 | 2007-09-24 |
| 1679717441 | Arizona Support Services and Intensive Skills Training, Inc. | Community/Behavioral Health | 2957 N Us Highway 89, Prescott, AZ 86301-4963 | 2009-04-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871102350 | Dove Marie Gundermann | Specialist/Technologist | 300 W. Gurley St, Prescott, AZ 86301 | 2020-07-30 |
| 1639712110 | Arizona Orthopedic Physical Therapy, Pllc | Clinic/Center | 1781 E State Highway 69, Suite 28, Prescott, AZ 86301 | 2019-10-28 |
| 1538714092 | Prescott Complete Care | Family Medicine | 1947 Commerce Center Circle, Suite A, Prescott, AZ 86301 | 2019-08-01 |
| 1336612571 | Sarah Elizabeth Elliott | Registered Nurse | 500 Az 89, Prescott, AZ 86301 | 2019-01-10 |
| 1912484270 | Asya Ruth Perkins | Counselor | 225 Grove Avenue, Prescott, AZ 86301 | 2018-07-19 |
| 1396241394 | Jerome Alexander Longoria | Chiropractor | 142 N. Rush St, Prescott, AZ 86301 | 2018-03-30 |
| 1619487675 | Yavapai Healthcare Group LLC | Nurse Practitioner | 999 Division Street, Prescott, AZ 86301 | 2017-10-04 |
| 1053835843 | United States Veterans Initiative | Counselor | 917 E Gurley St, Prescott, AZ 86301 | 2017-08-02 |
| 1164896999 | Spitler - Lilley, LLC | Hearing Instrument Specialist | 1781 E. State Rte 69, Suite 65, Prescott, AZ 86301 | 2015-11-17 |
| 1275925265 | Oral and Facial Surgery Center of Prescott | Dentist | 5415 Distiction Way, Prescott, AZ 86301 | 2015-02-27 |
| Find all providers in zip 86301 | ||||
| Taxonomy Code | 385HR2055X |
| Grouping | Respite Care Facility |
| Classification | Respite Care |
| Specialization | Respite Care, Mental Illness, Child |
| A facility or distinct part of a facility that provides short term, residential care to children, diagnosed with mental illness, as respite for the regular caregivers. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518447598 | Jacqueline Schlosser | Respite Care | 237 S. Washington Ave., Prescott, AZ 86303 | 2018-08-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114539004 | Yvette I Haughton | Respite Care | 11275 N 99th Ave Lot 117, Peoria, AZ 85345-5479 | 2020-08-20 |
| 1700411576 | Jaquelina Andrea Reyes | Respite Care | 25279 W Centre Ave, Buckeye, AZ 85326-2468 | 2020-03-11 |
| 1740815497 | Jerome Alexander-terrell Jackson | Respite Care | 9680 W Northern Ave Unit 2311, Peoria, AZ 85345-4655 | 2020-03-03 |
| 1912539941 | Elizabeth Ann Mannel | Respite Care | 1225 W Panorama Rd, Tucson, AZ 85704-2834 | 2020-02-07 |
| 1093345498 | New Hope of Arizona, Inc. | Respite Care | 12545 W Woodland Ave, Avondale, AZ 85323-8025 | 2020-01-24 |
| 1033757877 | Jessica Annette Dixon-tatum | Respite Care | 401 N 6th St, Buckeye, AZ 85326-2415 | 2019-12-11 |
| 1700423902 | Randy Bland | Respite Care | 20731 W Stone Hill Road, Buckeye, AZ 85396 | 2019-12-06 |
| 1003459934 | Stephanie Denise Jackson | Respite Care | 22321 W Morning Glory St, Buckeye, AZ 85326-7181 | 2019-10-23 |
| 1285276345 | Charlyn Ponds | Respite Care | 235 E Ray Rd Apt 2035, Chandler, AZ 85225-3362 | 2019-10-10 |
| 1508416595 | Tyechia Webb | Respite Care | 21239 N 24th Ave Apt 214, Phoenix, AZ 85027-2524 | 2019-09-12 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.