Organization
BEACON HEALTH SERVICES, INC.
Active
Other names
Capistrano Beach Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
CRAE TYLER BERRETT (PRESIDENT)
(208) 251-1107
Entity
Organization
Contact information
Practice address
35410 DEL REY, CAPISTRANO BEACH, CA 92624-1814
(949) 496-5786
(949) 496-0540
Mailing address
35410 DEL REY, CAPISTRANO BEACH, CA 92624-1814
(949) 496-5786
(949) 496-0540
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZT05585J
—
CA
Enumeration date
05/22/2006
Last updated
08/22/2020
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