Good Samaritan Shelter
Organization Active NPI Substance Abuse Rehabilitation Facility · Santa Maria, CA
NPI 1487166120 · NPPES record last updated Nov 13, 2019
Key facts
- NPI
- 1487166120
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Substance Abuse Rehabilitation Facility 324500000X
- Legal business name
- GOOD SAMARITAN SHELTER
- Practice address
- 412 East Tunnell Street
Santa Maria, CA 93454 - Phone
- (805) 925-0315
- Fax
- (866) 594-7933
- NPI assigned
- Nov 3, 2017
- Organization subpart
- Yes
- Parent organization (as reported)
- GOOD SAMARITAN SHELTER
Authorized official
- Name
- Mrs. Donna Michell Flores, CADTP/CAODC
- Title
- Director of Treatment
- Phone
- (805) 266-3747
Other NPIs on the same Medicare enrollment 9
Corporate family (same tax ID) 29
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
- Part of
- Good Samaritan Shelter Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction Medicine (Family Medicine) Physician |
207QA0401X | |||
| Substance Abuse Rehabilitation Facility | 324500000X | Yes |
Addresses
Primary practice location
412 East Tunnell Street
Santa Maria, CA 93454
Mailing address
412 East Tunnell Street
Santa Maria, CA 93454
Phone (805) 925-0315
Other names
- Transitional Center for Women and Children
Other providers in Santa Maria, CA
- Good Samaritan Shelter
- Good Samaritan Shelter
- Good Samaritan Shelter
- Good Samaritan Shelter
- Good Samaritan Shelter
- Good Samaritan Shelter
- Good Samaritan Shelter
- Good Samaritan Shelter
- Good Samaritan Shelter
- Good Samaritan Shelter
All providers in Santa Maria, CA · Substance Abuse Rehabilitation Facility in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 13, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.