Organization · Type 2 NPI

Mentors Driving Change for Boys, Men and Dads

Community/Behavioral Health Agency · Watsonville, CA

NPI number 1033987631 Active

Practice location

15 Madison St
Watsonville, CA 95076-4490

Call (831) 588-7592 Map

Mailing address

PO Box 1585
Freedom, CA 95019-1585

Specialties and licenses

Taxonomy	Code	License
Community Health Worker	172V00000X	None listed
Community/Behavioral Health Agency Primary	251S00000X	None listed

Community/Behavioral Health Agency: A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day suppo…

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NPI record

NPI: 1033987631
Entity type: Organization (Type 2)
Issued: Dec 13, 2023
Last updated: Dec 13, 2023
Status: Active

Other names

Mentors Driving Change for Boys, Men and Dads · former legal business name

Authorized official

Deutron Kebebew
Executive Director/program Director
(831) 588-7592

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1033987631

Mentors Driving Change for Boys, Men and Dads's National Provider Identifier is 1033987631, issued on Dec 13, 2023. The primary taxonomy on file is Community/Behavioral Health Agency (251S00000X), and the practice location is in Watsonville, CA. The record was last updated on Dec 13, 2023.