Organization
STATE OF CALIFORNIA - DEPARTMENT OF DEVELOPMENTAL SERVICES
Active
Other names
Fairview Developmental Center
Organization subpart
No
Provider details
NPI number
Authorized official
CARLA CASTANEDA (CHIEF DEPUTY DIRECTOR)
(916) 654-2822
Entity
Organization
Contact information
Practice address
2501 HARBOR BLVD, COSTA MESA, CA 92626-6143
(714) 957-5000
(714) 957-5095
Mailing address
1215 O STREET, CFS: MS 10-30, SACRAMENTO, CA 95814
(916) 654-3463
(916) 653-4587
Taxonomy
Speciality
Code
Description
License number
State
282E00000X
Long Term Care Hospital
170000771
CA
282N00000X
General Acute Care Hospital
Primary
170000771
CA
314000000X
Skilled Nursing Facility
170000771
CA
315P00000X
Intellectual Disabilities Intermediate Care Facility
170000771
CA
333600000X
Pharmacy
170000771
CA
3336L0003X
Long Term Care Pharmacy
HPE9770
CA
Other
Enumeration date
05/12/2006
Last updated
04/07/2022
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