CSP Crisis Residential Program

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

License

MFT35212 Issued in CA

Legal business name

CSP CRISIS RESIDENTIAL PROGRAM

Practice address

980 Catalina
Laguna Beach, CA 92651-2748

Phone

(949) 494-4311

NPI assigned

Jan 24, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Carol Carlson

Title

Director

Phone

(949) 494-4311

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1063567378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "980 CATALINA",
            "city": "LAGUNA BEACH",
            "state": "CA",
            "postal_code": "926512748",
            "telephone_number": "949-494-4311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "980 CATALINA",
            "city": "LAGUNA BEACH",
            "state": "CA",
            "postal_code": "926512748",
            "telephone_number": "949-494-4311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CSP CRISIS RESIDENTIAL PROGRAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CARLSON",
        "authorized_official_first_name": "CAROL",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "949-494-4311",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "CA",
            "license": "MFT35212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Laguna Beach, CA
• Emotionally Disturbed Childrens' Residential Treatment Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.