Provider Demographics
NPI:1922464858
Name:DANIEL BRYANT ADOLESCENT TREATNENT CENTER SANTA MARIA
Entity Type:Organization
Organization Name:DANIEL BRYANT ADOLESCENT TREATNENT CENTER SANTA MARIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ED
Authorized Official - Middle Name:
Authorized Official - Last Name:STONEFELT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-722-1301
Mailing Address - Street 1:P.O.BOX 28
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93110
Mailing Address - Country:US
Mailing Address - Phone:805-963-1433
Mailing Address - Fax:
Practice Address - Street 1:526 EAST CHAPEL STREET
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93454
Practice Address - Country:US
Practice Address - Phone:805-925-8860
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNCIL ON ALCOHOLISM AND DRUG ABUSE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-01-07
Last Update Date:2016-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA4276251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management