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Organization
COSA SAN DIEGO
Active
Organization
COSA SAN DIEGO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS CORNWELL (DIRECTOR OF OPERATIONS)
(619) 871-4924
Entity
Organization
Contact information
Practice address
1112 SEACOAST DR APT 11, IMPERIAL BEACH, CA 91932-3131
(503) 318-5438
Mailing address
1112 SEACOAST DR APT 9, IMPERIAL BEACH, CA 91932-3131
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
251X00000X
Supports Brokerage Agency
Primary
—
—
Other
Enumeration date
08/24/2026
Last updated
09/03/2026
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