Organization
MENTORS DRIVING CHANGE FOR BOYS, MEN AND DADS
Active
Other names
MENtors Driving Change for Boys, Men and Dads
Organization subpart
No
Provider details
NPI number
Authorized official
DEUTRON KEBEBEW (EXECUTIVE DIRECTOR/PROGRAM DIRECTOR)
(831) 588-7592
Entity
Organization
Contact information
Practice address
15 MADISON ST, WATSONVILLE, CA 95076-4490
(831) 588-7592
Mailing address
PO BOX 1585, FREEDOM, CA 95019-1585
(831) 588-7592
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
12/13/2023
Last updated
12/13/2023
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