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Organization
SUPPORT OUR STUDENTS
Active
Organization
SUPPORT OUR STUDENTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ERIC LOFCHIE MFT (EXECUTIVE DIRECTOR)
(707) 364-5430
Entity
Organization
Contact information
Practice address
319 S E ST, SANTA ROSA, CA 95404-5175
(707) 364-5430
Mailing address
319 S E ST, SANTA ROSA, CA 95404-5175
(707) 364-5430
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
45788
CA
Other
Enumeration date
04/22/2015
Last updated
04/22/2015
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