Provider Demographics
NPI:1073974184
Name:VENTURA COUNTY BEHAVIORAL HEALTH ALCOHOL AND DRUG PROGRAM
Entity Type:Organization
Organization Name:VENTURA COUNTY BEHAVIORAL HEALTH ALCOHOL AND DRUG PROGRAM
Other - Org Name:THE VENTURA CENTER PACIFIC HIGH SCHOOL
Other - Org Type:Other Name
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:NARCISA
Authorized Official - Middle Name:
Authorized Official - Last Name:EGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-677-5140
Mailing Address - Street 1:1911 WILLIAMS DR
Mailing Address - Street 2:SUITE 210
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93036-2612
Mailing Address - Country:US
Mailing Address - Phone:805-981-5455
Mailing Address - Fax:
Practice Address - Street 1:501 COLLEGE DR
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-3413
Practice Address - Country:US
Practice Address - Phone:805-981-5455
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-16
Last Update Date:2016-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA56OtherDRUG MEDI-CAL