Organization
CASA CAPRI
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IAN ROY (INSURANCE DIRECTOR)
(916) 533-4285
Entity
Organization
Contact information
Practice address
4001 WESTERLY PL STE 110, NEWPORT BEACH, CA 92660-2302
(877) 713-2669
(877) 963-6329
Mailing address
4001 WESTERLY PL STE 110, NEWPORT BEACH, CA 92660-2302
(877) 713-2669
(877) 820-8959
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
300326EP
DHCS
CA
Enumeration date
06/15/2016
Last updated
02/19/2020
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