Provider Demographics
NPI:1225358633
Name:COUNCIL ON ALCOHOLISM AND DRUG ABUSE
Entity Type:Organization
Organization Name:COUNCIL ON ALCOHOLISM AND DRUG ABUSE
Other - Org Name:MAIN SCHOOL FAMILY RESOURCE CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR OF ADMINISTRATION
Authorized Official - Prefix:MR
Authorized Official - First Name:WIM
Authorized Official - Middle Name:
Authorized Official - Last Name:VERKAIK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-963-1433
Mailing Address - Street 1:232 E CANON PERDIDO ST
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93101-2242
Mailing Address - Country:US
Mailing Address - Phone:805-963-1433
Mailing Address - Fax:
Practice Address - Street 1:5201 8TH ST
Practice Address - Street 2:SUITE 312
Practice Address - City:CARPINTERIA
Practice Address - State:CA
Practice Address - Zip Code:93013-2495
Practice Address - Country:US
Practice Address - Phone:805-963-1433
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNCIL ON ALCOHOLISM AND DRUG ABUSE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-06-08
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA420022BN251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management