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Another Road Detox

Organization Active NPI Substance Abuse Rehabilitation Facility · Lompoc, CA

NPI 1043731987 · NPPES record last updated Dec 10, 2024

Key facts

NPI
1043731987
Entity type
Organization (NPI type 2)
Primary specialty
Substance Abuse Rehabilitation Facility 324500000X
Legal business name
ANOTHER ROAD DETOX
Practice address
113 South M Street
Lompoc, CA 93436
Phone
(805) 736-0357
Fax
(866) 929-9350
NPI assigned
Jun 30, 2017
Organization subpart
No

Authorized official

Name
Mrs. Donna Michelle Flores, CADTP/CAODC
Title
Director of Treatment
Phone
(805) 266-3747

Other NPIs on the same Medicare enrollment 9

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Corporate family (same tax ID) 29

Organizations that report the same tax identification number in the National Provider Directory.

View all 29

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20230703001507 CA Part B Supplier - Clinic/Group Practice 6204295603 Receives reassigned benefits from 4 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lompoc, CA; Santa Maria, CA

National Provider Directory

Tax ID family
Good Samaritan Shelter Inc (30 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X Yes

Addresses

Primary practice location

113 South M Street
Lompoc, CA 93436

Mailing address

113 South M Street
Lompoc, CA 93436
Phone (805) 736-0357

Other providers in Lompoc, CA

All providers in Lompoc, CA · Substance Abuse Rehabilitation Facility in California

Sources for this page

Verify at the official NPI Registry.