Healthcare Provider Details

I. General information

NPI: 1225106883
Provider Name (Legal Business Name): THE PHOENIX OF SANTA BARBARA, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4095 FOOTHILL RD APT. D
SANTA BARBARA CA
93110-1278
US

IV. Provider business mailing address

4095 FOOTHILL RD APT. D
SANTA BARBARA CA
93110-1278
US

V. Phone/Fax

Practice location:
  • Phone: 586-864-3883
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: MISS LINDSAY L PERRY
Title or Position: COUNSELOR
Credential:
Phone: 805-563-1916