Organization
CASA DEL MAR GROUP HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LES JOSEPH IVERSON MASTERS (ADMINISTRATOR)
(805) 934-5974
Entity
Organization
Contact information
Practice address
4615 CAMEO DR, ORCUTT, CA 93455-4552
(805) 934-5974
(805) 934-5974
Mailing address
4615 CAMEO DR, ORCUTT, CA 93455-4552
(805) 934-5974
(805) 934-5974
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
CA
Other
Enumeration date
01/17/2008
Last updated
01/17/2008
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