Organization
MISSION POSSIBLE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PALMER JOHNSON (LCSW)
(719) 492-9100
Entity
Organization
Contact information
Practice address
1520 N UNION BLVD STE 204, COLORADO SPRINGS, CO 80909-2840
(719) 635-9100
Mailing address
PO BOX 9100, COLORADO SPRINGS, CO 80932-0100
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9000156387
—
CO
Enumeration date
12/20/2019
Last updated
12/20/2019
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