| Living Evolution: An Outdoor Experiential Learning Program Inc. | |
|
6001 Buttler Lane Suite 206 Scotts Valley CA 95066 | |
| (831) 247-3984 | |
| Not Available |
| Full Name | Living Evolution: An Outdoor Experiential Learning Program Inc. |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 6001 Buttler Lane, Scotts Valley, California |
| Authorized Official Name and Position | Jorden R. Krimmer (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 8312473984 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Living Evolution: An Outdoor Experiential Learning Program Inc. 4678 Soquel Drive #362 Soquel CA 95073 Ph: (831) 247-3984 | Living Evolution: An Outdoor Experiential Learning Program Inc. 6001 Buttler Lane Suite 206 Scotts Valley CA 95066 Ph: (831) 247-3984 |
| NPI Number | 1912393612 |
|---|---|
| Provider Enumeration Date | 04/09/2015 |
| Last Update Date | 04/09/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912393612 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| 133NN1002X | Nutritionist - Nutrition, Education | (* (Not Available)) | Secondary |
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