# CSP CRISIS RESIDENTIAL PROGRAM

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063567378
- **Authorized official:** MRS. CAROL CARLSON (DIRECTOR)
- **Authorized official phone:** (949) 494-4311

## Contact information

- **Practice address:** 980 CATALINA, LAGUNA BEACH, CA 92651-2748
- **Practice address phone:** (949) 494-4311
- **Mailing address:** 980 CATALINA, LAGUNA BEACH, CA 92651-2748
- **Mailing address phone:** (949) 494-4311

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | MFT35212 | CA | Yes |

## Other

- **Enumeration date:** 01/24/2007
- **Last updated:** 08/22/2020