Provider Demographics
NPI:1326878380
Name:ISLA VISTA YOUTH PROJECTS
Entity type:Organization
Organization Name:ISLA VISTA YOUTH PROJECTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:GOODMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:805-705-6998
Mailing Address - Street 1:PO BOX 1332
Mailing Address - Street 2:
Mailing Address - City:GOLETA
Mailing Address - State:CA
Mailing Address - Zip Code:93116-1332
Mailing Address - Country:US
Mailing Address - Phone:805-705-6998
Mailing Address - Fax:
Practice Address - Street 1:5638 HOLLISTER AVE STE 200
Practice Address - Street 2:
Practice Address - City:GOLETA
Practice Address - State:CA
Practice Address - Zip Code:93117-3484
Practice Address - Country:US
Practice Address - Phone:805-685-6900
Practice Address - Fax:685-696-9805
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-05
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management
No251K00000XAgenciesPublic Health or Welfare
No251V00000XAgenciesVoluntary or Charitable
No251X00000XAgenciesSupports Brokerage
No252Y00000XAgenciesEarly Intervention Provider Agency
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health