Organization
COMMUNITY CONNECTION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH WILLIAM BOSTON (PROGRAM COORIDINATOR)
(831) 425-8132
Entity
Organization
Contact information
Practice address
300 HARVEY WEST BLVD, SANTA CRUZ, CA 95060-2103
(831) 425-8132
(831) 425-4581
Mailing address
300 HARVEY WEST BLVD, SANTA CRUZ, CA 95060-2103
(831) 425-8132
(831) 425-4581
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
04/25/2007
Last updated
07/01/2008
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