Casa Palmera Care Center, Inc.

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

CASA PALMERA CARE CENTER, INC.

Practice address

6305 Lusk Blvd
San Diego, CA 92121

Phone

(714) 828-1800

Fax

(714) 882-1186

NPI assigned

Jan 31, 2021

Organization subpart

Yes

Parent organization

CASA PALMERA CARE CENTER, INC.As reported in NPPES

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

Authorized official

Name

Magdalen Gustilo

Title

Director of Payer Relations

Phone

(714) 568-7667

Specialties & licenses 4

Addresses

Other names 1

• Casa Palmera, Lusk Doing business as

Tax ID family

Casa Palmera Care Center Inc2 organizations share this tax ID, including this one

Part of

Casa Palmera Care Center Inc

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Casa Palmera Care Center, Inc.

  • Substance Abuse Rehabilitation Facility
  • Del Mar, CA
  • NPI 1669468286
  NPD tax ID

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Casa Palmera Care Center, Inc.

  • Substance Abuse Rehabilitation Facility
  • Del Mar, CA
  • NPI 1669468286
  NPPES parent name

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

{
    "created_epoch": "1612051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710979200000",
    "number": "1740871979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18401 VON KARMAN AVE STE 500",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926128531",
            "telephone_number": "714-828-1800",
            "fax_number": "714-882-1186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6305 LUSK BLVD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92121",
            "telephone_number": "714-828-1800",
            "fax_number": "714-882-1186"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14750 El Camino Real",
            "address_purpose": "LOCATION",
            "city": "Del Mar",
            "state": "CA",
            "postal_code": "920144204",
            "country_code": "US",
            "telephone_number": "714-828-1800",
            "fax_number": "714-882-1186",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CASA PALMERA CARE CENTER, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CASA PALMERA CARE CENTER, INC.",
        "enumeration_date": "2021-01-31",
        "last_updated": "2024-03-21",
        "certification_date": "2024-03-21",
        "status": "A",
        "authorized_official_last_name": "GUSTILO",
        "authorized_official_first_name": "MAGDALEN",
        "authorized_official_title_or_position": "DIRECTOR OF PAYER RELATIONS",
        "authorized_official_telephone_number": "714-568-7667"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Casa Palmera, Lusk",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amelia Cary
• Christopher W. Cary, M.D.
• Martin D Cary, PH.D
• Phoenix Carzino
• Casa de Las Campanas, Inc.
• Janine Casale
• Diego Casali, MD
• Edwina Api Casanada, REGISTERED NURSE
• Maria Selena Casanova-Smith
• Maegan Casanova, PSYD

• All providers in San Diego, CA
• Substance Use Disorder Rehabilitation Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2024; 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.