Provider Demographics
NPI:1700380367
Name:SANTA BARBARA COUNTY DEPARTMENT OF BEHAVIORAL WELLNESS
Entity Type:Organization
Organization Name:SANTA BARBARA COUNTY DEPARTMENT OF BEHAVIORAL WELLNESS
Other - Org Name:LOMPOC RECOVERY LEARNING COMMUNITY
Other - Org Type:Other Name
Authorized Official - Title/Position:QA COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:GIZELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:MENDOZA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:805-934-6365
Mailing Address - Street 1:300 N SAN ANTONIO RD
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93110-1316
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:513 N G ST
Practice Address - Street 2:
Practice Address - City:LOMPOC
Practice Address - State:CA
Practice Address - Zip Code:93436-5377
Practice Address - Country:US
Practice Address - Phone:805-819-0460
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-20
Last Update Date:2018-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health