Basic Information
| Provider Information | |||||||||
| NPI: | 1679587224 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | GOLETA VALLEY COTTAGE HOSPITAL | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 689 | ||||||||
| Address2: | C/O FINANCE DEPARTMENT | ||||||||
| City: | SANTA BARBARA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 931020689 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8058798964 | ||||||||
| FaxNumber: | 8058798945 | ||||||||
| Practice Location | |||||||||
| Address1: | 351 S PATTERSON AVE | ||||||||
| Address2: | |||||||||
| City: | GOLETA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 931112403 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8059673411 | ||||||||
| FaxNumber: | 8056816437 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/28/2006 | ||||||||
| LastUpdateDate: | 09/12/2013 | ||||||||
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| AuthorizedOfficialLastName: | BRICHER | ||||||||
| AuthorizedOfficialFirstName: | JOAN | ||||||||
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| AuthorizedOfficialTitleorPosition: | SENIOR VICE PRESIDENT FINANCE/CFO | ||||||||
| AuthorizedOfficialTelephone: | 8055697294 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | 050000034 | CA | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
ID Information
| ID | Type | State | Issuer | Description | LTC55617F | 05 | CA | MEDICAID | LTC70106F | 05 | CA | MEDICAID |