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Organization
WILD SOULS RANCH
Active
Organization
WILD SOULS RANCH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAYA JIMENEZ-OSELL (EXECUTIVE DIRECTION)
(707) 617-0356
Entity
Organization
Contact information
Practice address
2870 NELSON LN, FORTUNA, CA 95540-1708
(707) 617-0356
Mailing address
2870 NELSON LN, FORTUNA, CA 95540-1708
(707) 617-0356
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
08/12/2025
Last updated
10/15/2025
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