WEST CENTRAL MENTAL HEALTH CENTER, INC.

Provider Demographics

• NPI: 1952987760
• Name: WEST CENTRAL MENTAL HEALTH CENTER, INC.
• Entity type: Organization
• Organization Name: WEST CENTRAL MENTAL HEALTH CENTER, INC.
• Other - Org Name: <UNAVAIL>
• Authorized Official - Title/Position: CEO
• Authorized Official - First Name: MANDY
• Authorized Official - Middle Name: JO
• Authorized Official - Last Name: KAISNER
• Authorized Official - Credentials: LPC
• Authorized Official - Phone: 719-275-2351
• Mailing Address - Street 1: 3225 INDEPENDENCE RD
• 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: 701 S 9TH ST
• Practice Address - City: CANON CITY
• Practice Address - State: CO
• Practice Address - Zip Code: 81212-4911
• Practice Address - Country: US
• Practice Address - Phone: 719-275-2351
• Practice Address - Fax: 719-269-9386
• EIN: <UNAVAIL>
• Is Organization Subpart?: No
• Enumeration Date: 2021-03-22
• Last Update Date: 2024-05-10

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization
Yes	261QM0801X	Ambulatory Health Care Facilities	Clinic/Center	Mental Health (Including Community Mental Health Center)