Organization
BUCKELEW PROGRAMS
Active
Other names
Buckelew Tamayo Village
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN CHRISTOPHER KUGHN LMFT (CEO)
(415) 457-6966
Entity
Organization
Contact information
Practice address
1700 YULUPA AVE, SANTA ROSA, CA 95405-7721
(707) 780-7239
Mailing address
1700 YULUPA AVE, SANTA ROSA, CA 95405-7721
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
05/07/2024
Last updated
05/21/2024
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