Provider Demographics
NPI:1770665887
Name:SANTA MARIA SUPPORT SERVICES
Entity Type:Organization
Organization Name:SANTA MARIA SUPPORT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARSHALL
Authorized Official - Middle Name:
Authorized Official - Last Name:LANGFELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-337-7950
Mailing Address - Street 1:1080 MARINA VILLAGE PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-6427
Mailing Address - Country:US
Mailing Address - Phone:510-337-7950
Mailing Address - Fax:510-337-7969
Practice Address - Street 1:201 S MILLER ST
Practice Address - Street 2:SUITE 104
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93454-5233
Practice Address - Country:US
Practice Address - Phone:805-348-1850
Practice Address - Fax:805-348-1856
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TELECARE CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-19
Last Update Date:2008-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)