Organization
CASA PACIFICA
Active
Parent organization
5450
Other names
none
Organization subpart
Yes
Provider details
NPI number
Legal business name
5450
Authorized official
MRS. MIZELLA NONE HAYWOOD ADMINSTRATION (DIRECTOR OF CREDENTIALING)
(805) 445-7800
Entity
Organization
Contact information
Practice address
1021 SCANDIA AVE, 49, VENTURA, CA 93004-2473
(805) 248-1705
(805) 987-0258
Mailing address
1722 LEWIS ROAD, 49, CAMIRRILO, CA 93004-2610
(805) 445-7800
(805) 987-0258
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
MFC29100
CA
Other
Enumeration date
11/19/2015
Last updated
11/19/2015
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