Provider Demographics
NPI:1063005585
Name:KIT CARSON COUNTY HEALTH SERVICE DISTRICT
Entity Type:Organization
Organization Name:KIT CARSON COUNTY HEALTH SERVICE DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:L
Authorized Official - Last Name:BRIEGEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-346-9481
Mailing Address - Street 1:182 16TH ST
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:CO
Mailing Address - Zip Code:80807-1649
Mailing Address - Country:US
Mailing Address - Phone:719-346-0366
Mailing Address - Fax:719-346-5459
Practice Address - Street 1:182 16TH ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:CO
Practice Address - Zip Code:80807-1649
Practice Address - Country:US
Practice Address - Phone:719-346-0366
Practice Address - Fax:719-346-5459
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-16
Last Update Date:2021-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation