Provider Demographics
NPI:1033292925
Name:CASA COLINA CENTERS FOR REHABILITATION INC
Entity Type:Organization
Organization Name:CASA COLINA CENTERS FOR REHABILITATION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:FELICE
Authorized Official - Middle Name:
Authorized Official - Last Name:LOVERSO
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:909-596-7733
Mailing Address - Street 1:PO BOX 6001
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91769-6001
Mailing Address - Country:US
Mailing Address - Phone:909-596-7733
Mailing Address - Fax:909-593-9417
Practice Address - Street 1:255 E BONITA AVENUE
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91767
Practice Address - Country:US
Practice Address - Phone:909-596-7733
Practice Address - Fax:909-593-7541
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA320700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities