Organization
E-ESHORA CCC, INC.
Active
Organization
E-ESHORA CCC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LINDA J. NEUTZ MA CATC IV/CCS 15096 (CHIEF EXECUTIVE OFFICER (CEO))
(805) 743-1515
Entity
Organization
Contact information
Practice address
601 E OCEAN AVE, SUITE 20, LOMPOC, CA 93436-6937
(805) 743-1515
(805) 819-0942
Mailing address
1324 MARIGOLD WAY, LOMPOC, CA 93436-8204
(805) 743-1515
(805) 819-0942
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
CCS #15096
CA
251V00000X
Voluntary or Charitable Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1760686489
COUNTY OF SANTA BARBARA ALCOHOL/DRUG & MENTAL HEALTH SERVICES MEDI-CAL PROVIDER
CA
Enumeration date
02/20/2015
Last updated
03/23/2017
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