Malcolm Bernard Jordan | Colorado Springs, CO • PECOS Search

Malcolm Bernard Jordan

Behavior Technician

Behavioral Health & Social Service Providers

1930 Frequent Flyer Pt, Colorado Springs, CO 80915-1500

PECOS Enrollment

Based on the most recent information from CMS, provider Malcolm Bernard Jordan does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1336750728
Provider Type
Individual
Full Name
Jordan, Malcolm Bernard
Gender
Male

Sole Proprietor
No
Enumeration Date
8/11/2020
Last Updated
8/11/2020

Contact Information

Practice Location

1930 Frequent Flyer Pt, Colorado Springs, CO 80915-1500

Unlisted Fax

Mailing Location

1930 Frequent Flyer Pt, Colorado Springs, CO 80915-1500

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 106S00000X Primary	Description Behavior Technician Behavioral Health & Social Service Providers	License Unlisted Issuer