Healthcare Provider Details

I. General information

NPI: 1750416632
Provider Name (Legal Business Name): GOOD SAMARITAN SHELTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

412B E TUNNELL ST
SANTA MARIA CA
93454-4146
US

IV. Provider business mailing address

731 S LINCOLN ST
SANTA MARIA CA
93458-6107
US

V. Phone/Fax

Practice location:
  • Phone: 805-925-0315
  • Fax:
Mailing address:
  • Phone: 805-346-8185
  • Fax: 805-346-8656

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. SYLVIA CAROLYN BARNARD
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 805-346-8185