Provider Demographics
NPI:1356477574
Name:COUNCIL ON ALCOHOLISM&DRUG ABUSE
Entity Type:Organization
Organization Name:COUNCIL ON ALCOHOLISM&DRUG ABUSE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:PENNY
Authorized Official - Middle Name:
Authorized Official - Last Name:JENKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-963-1433
Mailing Address - Street 1:615 E CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93454-5211
Mailing Address - Country:US
Mailing Address - Phone:805-925-2869
Mailing Address - Fax:
Practice Address - Street 1:133 E HALEY ST
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-2330
Practice Address - Country:US
Practice Address - Phone:805-564-6057
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty