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Organization

FIRST BAPTIST CHURCH OF LODI

Active
Parent organization
FIRST BAPTIST CHURCH OF LODI
Other names
One-Eighty Adolescent & Family Services
Organization subpart
Yes

Provider details

NPI number
Legal business name
FIRST BAPTIST CHURCH OF LODI
Authorized official
ALISON MCGREGOR MFT (EXEC DIR ONE-EIGHTY YOUTH PROGRAMS)
(209) 339-1616
Entity
Organization

Contact information

Practice address
17 W LOCKEFORD ST, LODI, CA 95240-2125
(209) 339-1616
Mailing address
17 W LOCKEFORD ST, LODI, CA 95240-2125
(209) 339-1616

Taxonomy

Speciality
Code
Description
License number
State
101YS0200X
School Counselor
1425
CA
106H00000X
Marriage & Family Therapist
101549
CA
251S00000X
Community/Behavioral Health Agency
Primary

Other

Enumeration date
04/23/2018
Last updated
04/23/2018
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