Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MIKE JORDAN
Active Sole ProprietorMIKE JORDAN is a Emotionally Disturbed Children Residential Treatment healthcare provider located in PUEBLO, Colorado. NPI 1790153039 is currently active in the NPPES registry. Verify at CMS.
Emotionally Disturbed Children Residential Treatment · PUEBLO, CO
Registration Details
- NPI Number
- 1790153039
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Sep 3, 2015 (10.968119095863 yrs)
- Last Updated
- Sep 3, 2015
- Sole Proprietor
- Yes
Practice Information
- Address
-
2928 WITHERS AVEPUEBLO, CO, 810081248Browse CO providers · Browse ZIP 81008
- Phone
- 7195438178
- Fax
- 7195458583
- Primary Specialty
-
Emotionally Disturbed Children Residential Treatment
320900000X
Other Emotionally Disturbed Children Residential Treatment Providers in PUEBLO, CO
| Name | Credential | NPI |
|---|---|---|
| SUZETTE BUTLER | — | 1174102974 |
| BARBARA A GONZALES | OWNER | 1215642566 |
| RAUL DELGADO | — | 1699565309 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.