Provider Demographics
NPI:1447697586
Name:MCB CLINICAL RESEARCH CENTERS, LLC
Entity type:Organization
Organization Name:MCB CLINICAL RESEARCH CENTERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SCALVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-634-6576
Mailing Address - Street 1:110 S. PARKSIDE DRIVE
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80910
Mailing Address - Country:US
Mailing Address - Phone:719-634-6576
Mailing Address - Fax:719-520-0775
Practice Address - Street 1:110 S. PARKSIDE DRIVE
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80910
Practice Address - Country:US
Practice Address - Phone:719-634-6576
Practice Address - Fax:719-520-0775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-30
Last Update Date:2013-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty