Organization
CASA CAPRI
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IAN ROY (BILLING DIRECTOR)
(949) 335-7598
Entity
Organization
Contact information
Practice address
687 GOVERNOR ST, COSTA MESA, CA 92627-2504
(877) 713-2669
Mailing address
4001 WESTERLY PL STE 110, NEWPORT BEACH, CA 92660-2302
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
300326DP
CA
Other
Enumeration date
09/25/2017
Last updated
05/20/2020
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