Organization
BE THE CHANGE IN MENTAL HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE KELLEY CRIPPEN (DIRECTOR OF INSURANCE/ FINANCES)
(530) 680-2810
Entity
Organization
Contact information
Practice address
2800 CLEVELAND AVE STE C, SANTA ROSA, CA 95403-2784
(555) 555-5555
Mailing address
2800 CLEVELAND AVE STE A, SANTA ROSA, CA 95403-2784
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
Other
Enumeration date
03/11/2021
Last updated
02/12/2024
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