Healthcare Provider Details

I. General information

NPI: 1063893428
Provider Name (Legal Business Name): AMERICAN RIVIERA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2015
Last Update Date: 05/21/2021
Certification Date: 05/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

403 E MONTECITO ST THIRD FLOOR
SANTA BARBARA CA
93101-1759
US

IV. Provider business mailing address

403 E MONTECITO ST THIRD FLOOR
SANTA BARBARA CA
93101-1759
US

V. Phone/Fax

Practice location:
  • Phone: 805-883-1155
  • Fax:
Mailing address:
  • Phone: 805-883-1155
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SAMUEL DEKIN
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 760-641-3972