NPIMap

Organization Active NPI

Good Samaritan Shelter

  • Substance Abuse Rehabilitation Facility
  • Lompoc, CA
National Provider Identifier
1962058297
Registry record updated Aug 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
GOOD SAMARITAN SHELTER
Practice address
608 W Ocean Ave
Lompoc, CA 93436-6630
Phone
(805) 736-0357
NPI assigned
Aug 13, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2019

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

Authorized official

Name
Donna Flores
Title
Director of Treatment
Phone
(805) 266-3747

Specialties & licenses 1

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

Addresses

Primary practice location

608 W Ocean Ave
Lompoc, CA 93436-6630

Mailing address

245 Inger Dr # 103B
Santa Maria, CA 93454-8669
Phone (805) 346-8185

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

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

Other NPIs on the same Medicare enrollment 9

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

National Provider Directory

National Provider Directory
Tax ID family
Good Samaritan Shelter Inc30 organizations share this tax ID, including this one

Other organizations with this tax ID 29

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

View all 29

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1565654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1565654400000",
    "number": "1962058297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 INGER DR # 103B",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934548669",
            "telephone_number": "805-346-8185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "608 W OCEAN AVE",
            "city": "LOMPOC",
            "state": "CA",
            "postal_code": "934366630",
            "telephone_number": "805-736-0357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOD SAMARITAN SHELTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-13",
        "last_updated": "2019-08-13",
        "status": "A",
        "authorized_official_last_name": "FLORES",
        "authorized_official_first_name": "DONNA",
        "authorized_official_title_or_position": "DIRECTOR OF TREATMENT",
        "authorized_official_telephone_number": "805-266-3747"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lompoc, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.