Co. of San Luis Obispo

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

License

P0602150905 Issued in CA

Legal business name

CO. OF SAN LUIS OBISPO

Doing business as

san luis obispo county drug and alcohol service

Practice address

1523 Longbranch Ave
Grover Beach, CA 93433-2508

Phone

(805) 473-7080

Fax

(805) 473-7188

NPI assigned

Aug 19, 2014

Last updated

Aug 19, 2014By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Madalyn Bethann Hansen, M-R.A.S.

Title

Case Manager

Phone

(805) 704-7612

Specialties & licenses 1

Addresses

Other names 1

• san luis obispo county drug and alcohol service Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1408406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408406400000",
    "number": "1134528805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1523 LONGBRANCH AVE",
            "city": "GROVER BEACH",
            "state": "CA",
            "postal_code": "934332508",
            "telephone_number": "805-473-7080",
            "fax_number": "805-473-7188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1523 LONGBRANCH AVE",
            "city": "GROVER BEACH",
            "state": "CA",
            "postal_code": "934332508",
            "telephone_number": "805-473-7080",
            "fax_number": "805-473-7188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CO. OF SAN LUIS OBISPO",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-19",
        "last_updated": "2014-08-19",
        "status": "A",
        "authorized_official_last_name": "HANSEN",
        "authorized_official_first_name": "MADALYN",
        "authorized_official_middle_name": "BETHANN",
        "authorized_official_title_or_position": "CASE MANAGER",
        "authorized_official_telephone_number": "805-704-7612",
        "authorized_official_credential": "M-R.A.S."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "CA",
            "license": "P0602150905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "san luis obispo county drug and alcohol service",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Case Management Agency in Grover Beach, CA
• Providers in Grover Beach, CA by specialty
• Case Management Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.