Provider Demographics
NPI:1912505397
Name:WEST CENTRAL MENTAL HEALTH CENTER, INC.
Entity Type:Organization
Organization Name:WEST CENTRAL MENTAL HEALTH CENTER, INC.
Other - Org Name:SOLVISTA HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MANDY
Authorized Official - Middle Name:JO
Authorized Official - Last Name:KAISNER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:719-275-2351
Mailing Address - Street 1:3225 INDEPENDENCE RD
Mailing Address - Street 2:
Mailing Address - City:CANON CITY
Mailing Address - State:CO
Mailing Address - Zip Code:81212-9380
Mailing Address - Country:US
Mailing Address - Phone:719-275-2351
Mailing Address - Fax:719-269-9386
Practice Address - Street 1:714 FRONT ST
Practice Address - Street 2:
Practice Address - City:LEADVILLE
Practice Address - State:CO
Practice Address - Zip Code:80461-3921
Practice Address - Country:US
Practice Address - Phone:719-486-6502
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-16
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health