Provider Demographics
NPI:1932752342
Name:CHANNEL ISLANDS
Entity Type:Organization
Organization Name:CHANNEL ISLANDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/CLINICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLISON
Authorized Official - Middle Name:
Authorized Official - Last Name:HOPKINS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:214-934-8999
Mailing Address - Street 1:4744 TELEPHONE RD STE 3-248
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-5244
Mailing Address - Country:US
Mailing Address - Phone:214-934-8999
Mailing Address - Fax:
Practice Address - Street 1:145 SANTA ROSA AVE
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93035-4475
Practice Address - Country:US
Practice Address - Phone:805-794-0053
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-24
Last Update Date:2019-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility