Organization
MENTALLY ILL KIDS IN DISTRESS
Active
Other names
MIKID
Organization subpart
No
Provider details
NPI number
Authorized official
MATT AUNA BHT (CEO)
(480) 414-4879
Entity
Organization
Contact information
Practice address
810 GEMSTONE AVE STE 1&2&3, BULLHEAD CITY, AZ 86442-6476
(928) 733-0093
(928) 636-9904
Mailing address
7816 N 19TH AVE, PHOENIX, AZ 85021-7036
(480) 414-4879
(602) 253-1250
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
APPLICATION
AZ
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
10/29/2010
Last updated
12/05/2025
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