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General NPI Number Information
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NPI Number | 1932211596
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Entity Type | Organization
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Legal Business Name | KIT CARSON COUNTY HEALTH SERVICES DISTRICT
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 02/23/2021
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Provider Practice Location Address
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Address Line | 182 16TH ST
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City | BURLINGTON
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State | CO
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Zip | 80807-1649
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Country | US
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Telephone | 719-346-9481
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Fax | 719-346-9485
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Provider Business Mailing Address
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Address Line | 182 16TH ST
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City | BURLINGTON
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State | CO
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Zip | 80807-1649
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Country | US
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Telephone | 719-346-9481
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Fax | 719-346-9485
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Authorized Official
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Title or Position | MANAGER
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Name | BRENDA L BRIEGEL
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Credential |
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Telephone | 719-346-9481
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number | 0905
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License Number State | CO
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