Provider Demographics
NPI:1952436297
Name:PROJECT RECOVERY, DROP-IN CENTER
Entity type:Organization
Organization Name:PROJECT RECOVERY, DROP-IN CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DROP-IN CENTER DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHAN
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:GONZALES
Authorized Official - Suffix:
Authorized Official - Credentials:CAARR LDAC
Authorized Official - Phone:805-962-6195
Mailing Address - Street 1:PO BOX 28
Mailing Address - Street 2:133 E. HALEY STREET
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93102-0028
Mailing Address - Country:US
Mailing Address - Phone:805-962-6195
Mailing Address - Fax:805-963-8849
Practice Address - Street 1:133 E HALEY ST
Practice Address - Street 2:133 E. HALEY STREET
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-2330
Practice Address - Country:US
Practice Address - Phone:805-962-6195
Practice Address - Fax:805-963-8849
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-23
Last Update Date:2008-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA420022AN324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility