Individual ProviderJim R KlockSocial WorkerBehavioral Health & Social Service ProvidersPractice Address760 Whalers Way, Suite C-200, Fort Collins, CO 80525-3370(970) 495-4853PECOS EnrollmentBased on the most recent information from CMS, provider Jim R Klock does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1093876484Provider TypeIndividualFull NameKlock, Jim RCredentialLCSWGenderMaleSole ProprietorYesEnumeration Date12/12/2006Last Updated7/8/2007Contact InformationPractice LocationPractice Address760 Whalers Way, Suite C-200, Fort Collins, CO 80525-3370Phone(970) 495-4853Fax(970) 204-7883Mailing LocationMailing Address1907 Topanga Ct, Ft Collins, CO 80528-6278Phone(970) 495-4853Fax(970) 204-7883Provider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense989163Colorado