| Support Our Students | |
|
319 S E St Santa Rosa CA 95404-5175 | |
| (707) 364-5430 | |
| Not Available |
| Full Name | Support Our Students |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 319 S E St, Santa Rosa, California |
| Authorized Official Name and Position | Eric Lofchie (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 7073645430 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Support Our Students 319 S E St Santa Rosa CA 95404-5175 Ph: (707) 364-5430 | Support Our Students 319 S E St Santa Rosa CA 95404-5175 Ph: (707) 364-5430 |
| NPI Number | 1245627793 |
|---|---|
| Provider Enumeration Date | 04/22/2015 |
| Last Update Date | 04/22/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245627793 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 45788 (California) | Primary |
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