Active NPI
Casa Capri
- Substance Abuse Rehabilitation Facility
- Costa Mesa, CA
National Provider Identifier
1841640307
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Substance Abuse Rehabilitation Facility
- Legal business name
- CASA CAPRI
- Practice address
- 671 Governor St
Costa Mesa, CA 92627-2504 - Phone
- (877) 713-2669
- Fax
- (877) 820-8959
- NPI assigned
- Jun 15, 2016
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Ian Roy
- Title
- Insurance Director
- Phone
- (916) 533-4285
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric Residential Treatment Facility | 323P00000X | |||
| Substance Abuse Rehabilitation Facility | 324500000X | Primary |
Addresses
Primary practice location
671 Governor St
Costa Mesa, CA 92627-2504
Mailing address
4001 Westerly PL Ste 110
Newport Beach, CA 92660-2302
Phone (877) 713-2669
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 300326CP | Other | CA | DHCS |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 05D2112021 | Casa Capri Recovery, LLC | Certificate of waiver | Apr 19, 2028 |
National Provider Directory
National Provider Directory- Tax ID family
- Casa Capri
Other organizations with this tax ID 5
Organizations that report the same tax identification number in the National Provider Directory.
-
- Substance Abuse Rehabilitation Facility
- Costa Mesa, CA
- NPI 1013426816
-
- Substance Abuse Rehabilitation Facility
- Costa Mesa, CA
- NPI 1366892838
-
- Substance Use Disorder Rehabilitation Clinic/Center
- Newport Beach, CA
- NPI 1841640315
-
- Substance Abuse Rehabilitation Facility
- Costa Mesa, CA
- NPI 1669005575
-
- Substance Use Disorder Rehabilitation Clinic/Center
- Newport Beach, CA
- NPI 1225927767
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1465948800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1589932800000",
"number": "1841640307",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4001 WESTERLY PL STE 110",
"city": "NEWPORT BEACH",
"state": "CA",
"postal_code": "926602302",
"telephone_number": "877-713-2669",
"fax_number": "877-963-6329"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "671 GOVERNOR ST",
"city": "COSTA MESA",
"state": "CA",
"postal_code": "926272504",
"telephone_number": "877-713-2669",
"fax_number": "877-820-8959"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CASA CAPRI",
"organizational_subpart": "NO",
"enumeration_date": "2016-06-15",
"last_updated": "2020-05-20",
"certification_date": "2020-05-20",
"status": "A",
"authorized_official_last_name": "ROY",
"authorized_official_first_name": "IAN",
"authorized_official_title_or_position": "INSURANCE DIRECTOR",
"authorized_official_telephone_number": "916-533-4285",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "323P00000X",
"taxonomy_group": "",
"desc": "Psychiatric Residential Treatment Facility",
"state": null,
"license": null,
"primary": false
},
{
"code": "324500000X",
"taxonomy_group": "",
"desc": "Substance Abuse Rehabilitation Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DHCS",
"identifier": "300326CP",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Costa Mesa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.