Provider Demographics
NPI:1699172247
Name:KIT CARSON COUNTY DEPT. OF PUBLIC HEALTH AND ENVORNIMENT
Entity type:Organization
Organization Name:KIT CARSON COUNTY DEPT. OF PUBLIC HEALTH AND ENVORNIMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:M
Authorized Official - Last Name:JAMES
Authorized Official - Suffix:
Authorized Official - Credentials:CNO
Authorized Official - Phone:719-346-7642
Mailing Address - Street 1:252 S 14TH ST
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:CO
Mailing Address - Zip Code:80807-2321
Mailing Address - Country:US
Mailing Address - Phone:719-346-7158
Mailing Address - Fax:719-346-8066
Practice Address - Street 1:252 S 14TH ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:CO
Practice Address - Zip Code:80807-2321
Practice Address - Country:US
Practice Address - Phone:719-346-7158
Practice Address - Fax:719-346-8066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-25
Last Update Date:2021-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1851363865251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare