Organization
BUCKELEW PROGRAMS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN CHRISTOPHER KUGHN LMFT (CEO)
(415) 457-6966
Entity
Organization
Contact information
Practice address
2235 MERCURY WAY STE 107, SANTA ROSA, CA 95407-5472
(707) 571-5581
Mailing address
2235 MERCURY WAY STE 107, SANTA ROSA, CA 95407-5472
(707) 571-5581
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
03/04/2024
Last updated
08/19/2024
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