Casa del Mar Group Home

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

Legal business name

CASA DEL MAR GROUP HOME

Practice address

4615 Cameo Dr
Orcutt, CA 93455-4552

Phone

(805) 934-5974

Fax

(805) 934-5974

NPI assigned

Jan 17, 2008

Last updated

Jan 17, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Les Joseph Iverson, MASTERS

Title

Administrator

Phone

(805) 934-5974

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1689850802. Details of each certification follow.

• CCN 55G589 Intermediate care facility for individuals with intellectual disabilities · Active · Name & address match · Details

Intermediate care facility for individuals with intellectual disabilities certification: CCN 55G589

Legal name

Casa Del Mar

Certification status

Active

Provider type (POS)

Intermediate care facility for individuals with intellectual disabilities

Participating since

Dec 21, 2007

Last certification

Jun 18, 2025

Beds

6

Ownership / control type

Private (proprietary)

Facility address

4615 Cameo Drive
Orcutt, CA 93455

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

{
    "created_epoch": "1200528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200528000000",
    "number": "1689850802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4615 CAMEO DR",
            "city": "ORCUTT",
            "state": "CA",
            "postal_code": "934554552",
            "telephone_number": "805-934-5974",
            "fax_number": "805-934-5974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4615 CAMEO DR",
            "city": "ORCUTT",
            "state": "CA",
            "postal_code": "934554552",
            "telephone_number": "805-934-5974",
            "fax_number": "805-934-5974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CASA DEL MAR GROUP HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-17",
        "last_updated": "2008-01-17",
        "status": "A",
        "authorized_official_last_name": "IVERSON",
        "authorized_official_first_name": "LES",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "805-934-5974",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MASTERS"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Candace Curran Bendele, PHD, LMFT, BCBA-D
• Connor Bentley
• Michael I Callis, PH.D., MSCP
• Moises Caro, LMFT
• Mikaela Carrillo
• Eric Castle, DMD, MS
• Susan R Catron, BS OTR/L
• Daniela Ceja Gomez
• Coast to Coast Medical Transportation
• Kathryn L Connors, LAC

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Orcutt, CA
• Providers in Orcutt, CA by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.