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Organization Name: *

Website:

Email Address: *

Phone: *

County:

Address: *

Eligibility Requirements:

Population Served:

Services Provided:

Priority Services:

Domestic Violence Help

Veterans

Recovery

Recuperative Care

Housing:

Food & Supplies:

Transportation:

Child Care:

Medical:

Immunizations

Testings / Screenings / Health Fairs

Medical Treatment: General

Medical Treatment: Mental Health

Medical Treatment: Substance Abuse

Medical Treatment: Home Health

Medical Treatment: Physical Therapy

Medical Treatment: Dental

Medical Treatment: Optical (Eyeglasses)

Counseling / Support Group:

Education / Employment:

Financial Help:

Legal Assistance:

Additional Notes: