Healthcare Provider Details

I. General information

NPI: 1699823062
Provider Name (Legal Business Name): TRANSITIONAL LIVING CENTER AT SANTA BARBARA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 06/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1135 N PATTERSON AVE
SANTA BARBARA CA
93111-1113
US

IV. Provider business mailing address

1135 N PATTERSON AVE
SANTA BARBARA CA
93111-1113
US

V. Phone/Fax

Practice location:
  • Phone: 805-683-1995
  • Fax: 805-683-4793
Mailing address:
  • Phone: 805-683-1995
  • Fax: 805-683-4793

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number421703368
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code320700000X
TaxonomyPhysical Disabilities Residential Treatment Facility
License Number421703369
License Number StateCA

VIII. Authorized Official

Name: MS. SUSAN E. HANNIGAN
Title or Position: DIRECTOR
Credential: OTRL, CCM
Phone: 805-683-1995