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Organization
CASA NOVA ICF/DD-H
Active
Organization
CASA NOVA ICF/DD-H
Active
Parent organization
YTR HOMES ICF/DD-H
Organization subpart
Yes
Provider details
NPI number
Legal business name
YTR HOMES ICF/DD-H
Authorized official
MS. YOLANDA RUIZ (LICENSEE/CFO)
(650) 303-0788
Entity
Organization
Contact information
Practice address
3937 CASANOVA DR, SAN MATEO, CA 94403-3614
(650) 341-9620
(650) 525-1167
Mailing address
3937 CASANOVA DR, SAN MATEO, CA 94403-3614
(650) 341-9620
(650) 525-1167
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LTC 60829F
—
CA
Enumeration date
04/01/2008
Last updated
04/01/2008
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