# BUCKELEW PROGRAMS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376300517
- **Authorized official:** JOHN CHRISTOPHER KUGHN LMFT (CEO)
- **Authorized official phone:** (415) 457-6966

## Contact information

- **Practice address:** 2235 MERCURY WAY STE 107, SANTA ROSA, CA 95407-5472
- **Practice address phone:** (707) 571-5581
- **Mailing address:** 2235 MERCURY WAY STE 107, SANTA ROSA, CA 95407-5472
- **Mailing address phone:** (707) 571-5581

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251B00000X | Case Management Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 03/04/2024
- **Last updated:** 08/19/2024