| NPI | 1033987631 |
|---|---|
| Former Legal Business Name | MENTORS DRIVING CHANGE FOR BOYS, MEN AND DADS |
| Entity Type | Organization |
| Authorized Contact | DEUTRON KEBEBEW Executive Director/Program Director 831-588-7592 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 172V00000X Community Health Worker |
| Enumeration Date | 2023-12-13 |
| Last Update Date | 2023-12-13 |