| Buckelew Community Response Team | |
|
983 Sonoma Ave Santa Rosa CA 95404-4818 | |
| (707) 583-5284 | |
| Not Available |
| Full Name | Buckelew Community Response Team |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 983 Sonoma Ave, Santa Rosa, California |
| Authorized Official Name and Position | John Christopher Kughn (CEO) |
| Authorized Official Contact | 4154576966 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Buckelew Community Response Team 201 Alameda Del Prado Ste 103 Novato CA 94949-6698 Ph: () - | Buckelew Community Response Team 983 Sonoma Ave Santa Rosa CA 95404-4818 Ph: (707) 583-5284 |
| NPI Number | 1679340897 |
|---|---|
| Provider Enumeration Date | 12/07/2023 |
| Last Update Date | 01/03/2024 |
| Certification Date | 01/03/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679340897 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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