Provider Demographics
NPI:1104009075
Name:CASA JUANA MARIA, MHA
Entity Type:Organization
Organization Name:CASA JUANA MARIA, MHA
Other - Org Name:MENTAL WELLNESS CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR OF RESIDENTIAL SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:PAPAGEORGE
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:805-884-8440
Mailing Address - Street 1:617 GARDEN ST
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93101-1664
Mailing Address - Country:US
Mailing Address - Phone:805-845-3246
Mailing Address - Fax:805-884-8440
Practice Address - Street 1:106 JUANA MARIA AVE
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93103-2714
Practice Address - Country:US
Practice Address - Phone:805-898-0129
Practice Address - Fax:805-682-0906
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-13
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness