Organization
CSP CRISIS RESIDENTIAL PROGRAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CAROL CARLSON (DIRECTOR)
(949) 494-4311
Entity
Organization
Contact information
Practice address
980 CATALINA, LAGUNA BEACH, CA 92651-2748
(949) 494-4311
Mailing address
980 CATALINA, LAGUNA BEACH, CA 92651-2748
(949) 494-4311
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
MFT35212
CA
Other
Enumeration date
01/24/2007
Last updated
08/22/2020
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