Organization
SAN DIEGO YOUTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES G CASSON (CHILD CARE WORKER / REHABILITATION)
(858) 366-3199
Entity
Organization
Contact information
Practice address
968 CORTE MARIA AVE, CHULA VISTA, CA 91911-2219
(510) 565-6742
Mailing address
3255 WING ST, SAN DIEGO, CA 92110-4638
(619) 221-8600
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
01/29/2010
Last updated
01/29/2010
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