Organization
TURNING LEAF WELLNESS CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD BUSTAMANTE CSWA (CO-OWNER)
(559) 978-0302
Entity
Organization
Contact information
Practice address
1706 NE SHALE CT, ROSEBURG, OR 97470-5751
(559) 978-0302
Mailing address
1706 NE SHALE CT, ROSEBURG, OR 97470-5751
(559) 978-0302
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
02/18/2025
Last updated
04/21/2025
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