Organization
CASA CAPRI RECOVERY LLC
Active
Other names
Casa Capri
Organization subpart
No
Provider details
NPI number
Authorized official
IAN ROY (BILLING DIRECTOR)
(949) 446-6288
Entity
Organization
Contact information
Practice address
675 GOVERNOR ST, COSTA MESA, CA 92627-2504
(877) 713-2669
Mailing address
4001 WESTERLY PL STE 110, NEWPORT BEACH, CA 92660-2302
(877) 713-2669
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
300326FP
DHCS
CA
Enumeration date
02/19/2020
Last updated
05/20/2020
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